A Randomized, Masked Comparison of Topical Ketorolac 0.4% Plus Steroid vs Steroid Alone in Low-Risk Cataract Surgery Patients

Ketorolac therapy for the prevention of acute pseudophakic cystoid macular edema: a systematic review

“…When analyzed individually, each individual study was statistically nonsignificant in its findings, with the exception of the Wittpenn study. 9 When the pooled relative risk was calculated, the large sample size of this systematic review led to overall statistical significance. The authors attribute this to the review's large sample size and not to the individual studies themselves.…”

“…The Almeida, Donnenfeld, and Wittpenn studies were determined to have a statistical power of 2.5%, 45.1%, and 53.1%, respectively. 9,10,12 The power of the Chatiziralli study 11 was inestimable because of the fact that there were no incidents of CME in either group.…”

“…9,10 This compromise of objectivity raises concerns when interpreting these trials. As shown in a review of 370 RCTs, studies funded by for-profit organizations were 5.3 times more likely (95% CI, 2.0-14.4) than non-profit organizations to recommend the experimental drug as the treatment of choice.…”

“…Wittpenn et al 9 reported two serious adverse events: a case of endophthalmitis and the death of a study participant (unrelated to the study medication).…”

“…8 More specifically, several randomized controlled clinical trials (RCTs) have revealed the potential benefit of one of these topical NSAIDs, ketorolac tromethamine (Acular LS, Allergan Inc., Irvine, CA, USA), in the management of acute pseudophakic CME. [9][10][11][12] The purpose of this systematic review is to assess the effectiveness of ketorolac vs control in the treatment of acute pseudophakic CME (necessitating therapeutic intervention within 4 months of CME onset). [13][14][15] …”