A multicenter comparison of the ocular efficacy and safety of diclofenac 0.1% solution with that of ketorolac 0.5% solution in patients with acute seasonal allergic conjunctivitis.

Only one of several available ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) is currently FDA approved for use in acute seasonal allergic conjunctivitis (SAC). Sixty patients with SAC and moderate itching and bulbar conjunctival injection were enrolled in a multicenter, randomized, double-masked, parallel-group trial comparing diclofenac sodium (DS) with ketorolac tromethamine (KT). Patients instilled 1 drop four times daily while awake for 14 days. Ocular signs and symptoms were evaluated at one and two weeks. The primary efficacy variables were itching and bulbar conjunctival injection. For both treatments, the ocular allergy sign and symptom scores were comparable at baseline. Both treatments evaluated in this study were well tolerated. Significant clinical and statistical reductions from baseline were observed in the primary efficacy variables. Treatment group differences were observed for the pain/soreness score with an advantage observed for the DS group at 30 minutes and at day 7. Our conclusion is that diclofenac sodium and ketorolac tromethamine acted similarly to reduce the ocular signs and symptoms associated with acute seasonal allergic conjunctivitis. There was a statistically significant advantage for the DS group to be free of symptoms at the day 7 visit as compared to the KT group (20.7% vs. 3.2%).

Corneal wound healing strength with topical antiinflammatory drugs.

The objective of this study was to compare the force required to separate corneal wounds after topical applications of nonsteroidal antiinflammatory drugs (NSAIDs) or corticosteroids. Bilateral central 8-mm long corneal full-thickness incisions in 50 NZW rabbits were closed with five interrupted 10-0 nylon sutures. There were four paired-eye groups: (a) control/control, (b) control/diclofenac sodium (0.1%), (c) control/flurbiprofen sodium (0.03%), and (d) control/prednisolone acetate (1%) treated six times per day for 7 or 21 days. The wound strength was measured by determining the force necessary to separate the incision along its length. The eyes did not differ statistically from their contralateral eye for each group except control/diclofenac (7.98 g/12.32 g) and control/flurbiprofen (6.96 g/11.67 g) at 21 days. The strongest scars occurred after treatment with diclofenac and flurbiprofen, which were similar (p = 0.74). The weakest wounds for each time period were with prednisolone (1.74 g/3.21 g). The diclofenac and flurbiprofen were stronger than prednisolone-treated eyes at 7 days (p = 0.028 and p = 0.023, respectively) and at 21 days (p < 0.001). The bilateral controls were stronger than the prednisolone controls (p = 0.008 at 7 days and p = 0.001 at 21 days). Steroid treatment caused weaker corneal wound scars than did the NSAIDs. Unilateral steroid treatment adversely affected their untreated contralateral eyes. The NSAID-treated wounds were the strongest and stronger than their contralateral control eyes.