Ketorolac for the Regression of Myopic LASIK Overcorrection

Objective: To determine whether ketorolac (Acular™) treatment and other factors influence regression after LASIK-induced consecutive hyperopia. Methods: Seventy-two eyes of 51 patients who had undergone LASIK for myopia and compound myopic astigmatism and who experienced consecutive hyperopia of at least +0.50 diopters within the first postoperative week were analyzed. The consenting patients were treated with ketorolac (Acular™). Data were collected over a period of 2 months. Primary preoperative variables included age, eye, preoperative manifest and cycloplegic refractions, and pachymetry. Postoperative variables included presence of microstriae and treatment with ketorolac. Treatment success was measured as reduction of consecutive hyperopia. Results: Thirty-seven eyes were treated, and 35 eyes were in the control group. Mean start time for treatment with ketorolac was 9 days after surgery (range 3-35 days). Mean treatment time was 24.5 days (range 10-63 days). Both groups were matched for all preoperative variables except for age, including manifest and cycloplegic refraction, eye treated, and pachymetry. Treated patients were on average 9 years older than the control group. There was no significant difference in the overall rate of regression between the 2 groups at the 1-month and 2-month periods. Thicker preoperative corneas in all eyes had a sporadic association with reduction of consecutive hyperopia. Conclusions: Ketorolac does not improve consecutive hyperopia after LASIK for myopia and compound myopic astigmatism when compared with a matched control group. Pachymetry appears to be a determining factor in the degree of regression experienced after consecutive hyperopia. This finding warrants further investigation.