Perioperative Fixed Combination Of Levofloxacin 0.5% And Ketorolac 0.5% After Phacoemulsification: A Prospective Single-Centre Cohort Study

To evaluate the efficacy and safety of a fixed combination of levofloxacin 0.5% and ketorolac 0.5% for prevention of infectious complications and control of postoperative inflammation after uncomplicated phacoemulsification (PE) for age-related cataract.

The study was conducted in the Department of Ophthalmology, City Multidisciplinary Hospital No. 2, St. Petersburg, Russian Federation.

The study included 717 patients (803 eyes) undergoing uncomplicated PE for age-related cataract, examined on postoperative day 6 and day 15. Perioperative prophylaxis comprised a fixed combination of levofloxacin 0.5% and ketorolac 0.5% QID for 5 days plus fluorometholone 0.1% QID for 14 days from the day of surgery. The primary outcome was absence of anterior segment inflammation (conjunctival injection; anterior chamber cells and flare graded per SUN). Secondary outcomes were acute postoperative endophthalmitis, ocular surface fluorescein staining (Oxford), and tolerability.

No clinically detectable anterior segment inflammation was recorded in 98.8% of eyes at day 6 and in 100% at day 15. No cases of acute postoperative endophthalmitis were observed. Mild transient corneal staining (Oxford grade 1) occurred in 0.6% of cases at day 6 and resolved with lubricants at day 15. Transient instillation-related burning was reported in 2.2% without objective intolerance. No clinically significant steroid-related IOP elevations were reported.

A short postoperative course of a fixed combination of levofloxacin 0.5% and ketorolac 0.5% combined with fluorometholone 0.1% provided consistent inflammatory control with good tolerability after uncomplicated PE. The regimen simplifies postoperative therapy while maintaining clinically favorable outcomes.