Comparison and evaluation of ketorolac tromethamine 0.5%, ketotifen fumarate 0.05% and azelastine hydrochloride in patients of seasonal allergic conjunctivitis

Ocular allergy in the form of Seasonal Allergic Conjunctivitis is one of the most common conditions that ophthalmologists deal with. The signs and symptoms can be distressing and debilitating. The search is still on for the perfect topical drug with maximum efficacy and minimum side effects. We decided to undertake a study to compare and evaluate the efficacy of 3 commonly used drugs, topical Ketorolac tromethamine 0.5%, Ketotifen fumarate 0.05% and Azelastine hydrochloride in patients of Seasonal Allergic Conjunctivitis. 150 patients of Seasonal Allergic Conjunctivitis of both sexes in the age group of 15- 55 years were included. Patients included in the study had bilateral signs and symptoms of Seasonal Allergic Conjunctivitis. Group A patients were given Ketorolac tromethamine 0.5% to be instilled four times a day; Group B patients were given Ketotifen fumarate 0.05% to be instilled two times a day, and Group C patients were given Azelastine hydrochloride 0.05% to be instilled two times a day. The drops were dispensed in identical containers labeled A to C so that the patient did not know the type of drug administered. Informed consent was taken from all the patients. Patients were given the drugs on day 0 and the responses were assessed at 30 minutes (day 0), day 2, day 7, day 14, day 28 and 3 months. The drugs were instilled in both the eyes but the efficacy variables were studied in the eye with greater sign and symptoms. If both eyes had same grades of signs and symptoms, left eye of the patient was assessed. All 3 groups were age and sex matched. On each visit, the patient’s signs and symptoms were graded by the investigator and the total score was noted. During the course of the study, patients were asked regarding any side effects pertaining to the drugs being instilled. Drug A (Ketorolac) had a statistically significant difference as compared to Drug B (Ketotifen) at all follow-up intervals (p< 0.05), except at three month follow up, when there was no significant difference between them (p = 0.07). Also, Drug A had a statistically significant difference as compared to Drug C (Azelastine) throughout the study period (p< 0.05). On comparing Drug B and Drug C, we observed a significant difference from the seventh day onwards. All three drugs had a statistically significant improvement in the total score over baseline from the 30 minute period (p< 0.001).