Protaglandin E2 Inhibition and Aqueou Concentration of Ketorolac 0.4% (Acular L) and Nepafenac 0.1% (Nevanac) in Patient Undergoing Phacoemulification

Purpoe To determine the protaglandin E2 (PGE2) level and aqueou concentration achieved with ketorolac 0.4% (Acular L; Allergan, Inc, Irvine, California, UA) and nepafenac 0.1% (Nevanac; Alcon Laboratorie, Inc, Fort Worth, Texa, UA). Deign ingle-center, randomized, double-maked tudy. Method One hundred and thirty-two patient received ketorolac or nepafenac four time daily for two day before cataract extraction. Aqueou ample obtained at urgery were analyzed for PGE2 level (competitive enzyme immunoaay) and drug concentration. Reult More ketorolac eye than nepafenac eye had PGE2 level le than the level of detection (<100 pg/ml; 26/42 [61.9%] and 7/40 [17.5%], repectively; P < .001). Mean PGE2 level in ketorolac eye were lower than that in nepafenac eye (159.5 ± 114.66 pg/ml and 322 ± 197.8 pg/ml, repectively; P < .001). The mean aqueou level wa 1079.1 ± 881.5 ng/ml with ketorolac and 353.4 ± 126.0 ng/ml with amfenac. The nepafenac eye exhibited 588.4 ± 394.6 ng/ml of the inactive nepafenac molecule (P < .001 v ketorolac). Concluion Ketorolac 0.4% inhibited PGE2 and penetrated into aqueou ignificantly more than nepafenac 0.1%.