Eficacia del ketorolaco tópico para mejorar la función visual después de la fotocoagulación, en diabéticos con edema macular focal

Background: Photocoagulation reduces the incidence of visual loss in diabetic patients with focal macular edema, but it can induce it for 6 weeks after treatment and produces visual improvement in some cases. Topical ketorolac may reduce the inflammation caused by photocoagulation and improve visual outcome.

Purpose: To determine the efficacy of topical ketorolac for improving visual function after photocoagulation in diabetic patients with focal macular edema.

Methods: An experimental, comparative, prospective, longitudinal study in diabetic patients with focal macular edema was conducted. Eyes were randomized into two groups of topical treatment for 3 weeks after photocoagulation (A: ketorolac, B: placebo). Best corrected visual acuity before and after treatment was compared in each group (paired t test), and the proportion of eyes with visual improvement was compared between groups (χ2). The evaluation was repeated after stratifying for initial visual acuity (≥ 0.5, < 0.5).

Results: There were 105 eyes included. In group A (n= 46) mean visual acuity changed from 0.50 to 0.58 (p= 0.003), and from 0.55 to 0.55 in group B (n= 59, p= 0.83); mean percent change was 22.3% in group A and 3.5% in group B (p= 0.03). Visual improvement was identified in 25 eyes from group A (54.3%) and 19 from group B (32.2%, p= 0.019, RR 1.65); the difference only persisted when initial visual acuity was ≥ 0.5 (10 [40%], group A, 5 [14.7%], group B, p=0.02, RR 2.72).

Conclusion: Topical ketorolac was more effective than placebo to improve best corrected visual acuity in diabetic patients with focal macular edema.