Managing post-PRK discomfort

When treating post-phacorefractive keratectomy (PRK) discomfort, there are no significant differences in either safety or efficacy between bromfenac twice-daily and ketorolac four times daily, according to a study published in the February issue of the Journal of Refractive Surgery.

Neal A. Sher, MD, FACS - of the Department of Ophthalmology at the University of Minnesota Medical School, Minneapolis, US - and colleagues compared the two NSAIDs in terms of post-PRK prevention of pain, foreign body sensation, burning and light sensitivity, as well as epithelial healing rates by randomizing eyes (n=212) to receive one of the anti-inflammatories (bromfenac, n=105; ketorolac, n=107) in an open label trial. Any patient having two eyes treated received both medications, one for each eye. All eyes underwent PRK with the same technique, and were then fitted with the Acuvue Oasys bandage contact lens (Johnson & Johnson Vision Care) before receiving either bromfenac or ketorolac. Postoperatively, patients also received BSS, prednisolone acetate 1.0%, gatifloxacin ophthalmic solution 0.3% and, for some patients, mitomycin C 0.02%.

The drugs had similar epithelial healing rates, and neither was associated with a drug-related adverse event. Between the two drug populations, the research team did not note any significant differences in postoperative pain, burning, foreign body sensation or photophobia.

The team concluded that, following the usual post-PRK safety measures including application of cold BSS and use of a bandage contact lens, there are no differences in discomfort reduction between bromfenac twice daily and ketorolac four times daily.