Comparison of analgesic effect of preoperative topical diclofenac and ketorolac
on postoperative pain after photorefractive keratectomy.
Author(s): Hong JP(1), Nam SM(1), Im CY(1), Yoon S(1), Kim TI(1), Kim EK(1), Seo KY(2).
Affiliation(s): Author information:
(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.
Publication date & source: 2014, J Cataract Refract Surg. , 40(10):1689-96
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.
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