Are Topical Nonsteroidal Anti-inflammatory Drugs Effective on Cataract Surgery Outcome in Pseudoexfoliation Syndrom?

Purpose: Patients with pseudo-exfoliation syndrome (PEX) have a higher risk of inflammation after phacoemulsification surgery that can result in several complications in anterior and posterior segments. The present study aimed to evaluate the effect of adding topical ketorolac to steroids on anterior segment inflammation and complications. Methods: In this randomized clinical trial, ۸۸ patients with cataract and PEX, candidate of phacoemulsification surgery, were randomized to receive either ۵% chloramphenicol + ۰.۱% betamethasone with or without ۰.۵% ketorolac tromethamine eye drops for two weeks. Anterior chamber inflammation (ACI), intraocular pressure (IOP), and best corrected visual acuity (BCVA) were recorded ۱, ۳, ۷, and ۳۰ days after surgery and the degree of opacity of the anterior capsule (ACO) and opacity of the posterior capsule (PCO) six months after surgery were compared between the two groups using SPSS v.۲۱. Results: Forty-six patients were evaluated in ketorolac group and ۴۲ in the control (without ketorolac). IOP and BCVA were not different between two groups on days ۱, ۳, ۷, and ۳۰ after surgery (P>۰.۰۵). However, the group using ketorolac had less ACI on days ۳, ۷, and ۳۰ after surgery (P<۰.۰۵) and lower degrees of ACO and PCO six months after surgery (P<۰.۰۵). Conclusion: Addition of ketorolac eye drop to steroid eye drop after cataract surgery had additional effect on reducing ACI after cataract surgery in patients with cataract and PEX with additional effect on reducing ACO, and PCO.