Jin Pyo Hong1, Sang Min Nam1, Chan Young Im1, Sangchul Yoon1, Tae-Im Kim1, Eung Kweon Kim1, Kyoung Yul Seo2. 1. From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea. 2. From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea. Electronic address: seoky@yuhs.ac.
Abstract
PURPOSE: To investigate changes in the pain-suppressing potency of 2 preoperatively applied topical nonsteroidal antiinflammatory drugs (NSAIDs) after photorefractive keratectomy (PRK) using a time-serial pain-scoring system. SETTING: Saeyan Eye Center, Seoul, South Korea. DESIGN: Comparative case series. METHODS:Ninety-four patients were randomly assigned to 2 groups: ketorolac group (ketorolac 0.5% in 1 eye and ofloxacin 0.3% in the other eye) and diclofenac group (diclofenac 0.1% in 1 eye and ofloxacin 0.3% in the other eye). One drop of each ophthalmic drug was applied 3 times to each eye 30 minutes before PRK. No other NSAID or steroid was prescribed until 4 days after PRK. The patients were asked to score the postoperative pain in each eye with a visual analog scale at 6, 18, 24, 36, 48, 72, and 96 hours. RESULTS: The natural peak of pain was located between 24 and 36 hours. Initially, the degree of pain reduction was constant for both NSAIDs; it dropped after 24 hours and 36 hours in the ketorolac group and the diclofenac group, respectively. The postoperative time-serial pattern of the pain score changed in the diclofenac group but not in the ketorolac group compared with the pattern in the ofloxacin-treated eye. The visual outcome was not affected by either NSAID, and significant complications were not noticed for a mean of 7 months. CONCLUSIONS: The duration and pattern of the action may vary according to types of NSAIDs. Preemptive topical diclofenac 0.1% was a safe and effective method for post-PRK pain control. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
RCT Entities:
PURPOSE: To investigate changes in the pain-suppressing potency of 2 preoperatively applied topical nonsteroidal antiinflammatory drugs (NSAIDs) after photorefractive keratectomy (PRK) using a time-serial pain-scoring system. SETTING: Saeyan Eye Center, Seoul, South Korea. DESIGN: Comparative case series. METHODS: Ninety-four patients were randomly assigned to 2 groups: ketorolac group (ketorolac 0.5% in 1 eye and ofloxacin 0.3% in the other eye) and diclofenac group (diclofenac 0.1% in 1 eye and ofloxacin 0.3% in the other eye). One drop of each ophthalmic drug was applied 3 times to each eye 30 minutes before PRK. No other NSAID or steroid was prescribed until 4 days after PRK. The patients were asked to score the postoperative pain in each eye with a visual analog scale at 6, 18, 24, 36, 48, 72, and 96 hours. RESULTS: The natural peak of pain was located between 24 and 36 hours. Initially, the degree of pain reduction was constant for both NSAIDs; it dropped after 24 hours and 36 hours in the ketorolac group and the diclofenac group, respectively. The postoperative time-serial pattern of the pain score changed in the diclofenac group but not in the ketorolac group compared with the pattern in the ofloxacin-treated eye. The visual outcome was not affected by either NSAID, and significant complications were not noticed for a mean of 7 months. CONCLUSIONS: The duration and pattern of the action may vary according to types of NSAIDs. Preemptive topical diclofenac 0.1% was a safe and effective method for post-PRK pain control. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
Authors: Eva M Sobas; Sebastián Videla; Amanda Vázquez; Itziar Fernández; Miguel J Maldonado; José-Carlos Pastor Journal: Clin Ophthalmol Date: 2017-04-07
Authors: Eva M Sobas; Amanda Vázquez; Sebastián Videla; Roberto Reinoso; Itziar Fernández; Carmen Garcia-Vazquez; Miguel J Maldonado; J Carlos Pastor Journal: Clin Ophthalmol Date: 2020-03-03