Effect of preemptive topical diclofenac on postoperative pain relief after
photorefractive keratectomy.
Author(s): Mohammadpour M, Jabbarvand M, Nikdel M, Adelpour M, Karimi N.
Affiliation(s): Ophthalmology Department and Eye Research Center, Cornea Consultant, Farabi Eye
Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Publication date & source: 2011, J Cataract Refract Surg. , 37(4):633-7
PURPOSE: To assess the prophylactic effect of preoperative application of topical
diclofenac on postoperative pain control in patients having photorefractive
keratectomy (PRK).
SETTING: Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran,
Iran.
DESIGN: Randomized masked clinical trial.
METHODS: In this paired-eye study, patients having bilateral PRK received 1 drop
of diclofenac 0.1% in 1 eye and 1 drop of placebo in the fellow eye 2 hours
before PRK. Postoperatively, both arms of the trial (both eyes of each patient)
received topical diclofenac every 6 hours for 2 days. One day and 2 days
postoperatively, patients were asked to rate the perceived pain in each eye using
an 11-point verbal numerical rating scale. A trained examiner noted the
eye-specific responses.
RESULTS: All 70 patients (140 eyes) completed the study and were included in the
statistical analysis. Twenty-four hours after PRK, patients reported pain scores
that were clinically and statistically significantly lower in the eyes pretreated
with diclofenac than in the fellow eyes (0.97 versus 2.09) (P=.018). Pain scores
at 2 days did not differ significantly (P=.877).
CONCLUSION: Administration of a single drop of topical diclofenac 0.1% 2 hours
before PRK seemed to increase the efficacy of postoperative pain management in a
clinically and statistically significant manner.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any
material or method mentioned.
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