A study of topical nonsteroidal anti-inflammatory drops and no pressure patching in the treatment of corneal abrasions

Objective: To evaluate the effectiveness of an ophthalmic nonsteroidal anti-inflammatory drug (NSAID) in the treatment of noninfected, non-contact lens-related, traumatic corneal abrasions and no pressure patch. Design: A single-center, randomized, double-masked, placebo-controlled study. Participants: One hundred patients with noninfected, non-contact lens- related, traumatic or foreign body removal-related corneal abrasions less than 36 hours in duration. Intervention: All patients received a cycloplegic drop and erythromycin or polymyxin B (Polysporin Ophthalmic Ointment, Burroughs Wellcome, Research Triangle Park, NC). Patients were then randomized to receive either ketorolac tromethamine 0.5% ophthalmic solution or control vehicle drops. Main Outcome Measures: The main outcome measures were six subjective symptoms monitored daily, evaluation of corneal abrasion, and determination of adverse events. Long-term complications were determined 3 to 8 months after randomization. Results: Twelve patients were excluded from the study. One day after randomization, patients receiving ketorolac tromethamine 0.5% ophthalmic solution noted significantly decreased levels of pain (P < 0.002), photophobia (P < 0.009), and foreign body sensation (P < 0.003) as compared with the control vehicle group. In addition, the time to resumption of normal activities was shorter in the group who received ketorolac tromethamine 0.5% ophthalmic solution (P < 0.001). There was no statistical difference in the amount of tearing, healing time, acuity changes, or complication rates between the two groups. Conclusions: Ketorolac tromethamine 0.5% ophthalmic solution provides increased patient comfort without clinical adverse effects when used as adjunctive therapy in the treatment of noninfected, non-contact lens-related, traumatic corneal abrasions.