Pre-op topical analgesics vary in post-PRK pain control

The duration and pattern of action of pain-suppressing nonsteroidal anti-inflammatory drugs (NSAIDs) used prior to photorefractive keratotomy (PRK) varies with the NSAID used, according to South Korean researchers.

As reported in the Journal of Cataract and Refractive Surgery, the researchers conducted a comparative case series of 94 patients. The patients were randomly assigned to one of two groups. One group received ketorolac 0.5% in 1 eye and ofloxacin 0.3% in the other eye, the other group received diclofenac 0.1% in 1 eye and ofloxacin 0.3% in the other eye.

Three drops of each of the ophthalmic drugs were applied to each eye 30 minutes prior to PRK. The patients used a visual analogue scale to score the pain in each of their eyes at 6, 18, 24, 36, 48, 72 and 96 hours postoperatively.

The researchers found that the pain peaked between 24 and 36 hours postoperatively. The initial degree of pain reduction was constant for the NSAIDs, then dropped in the ketorolac group after 24 hours and in the diclofenac group after 36 hours. The postoperative time-serial pattern of the pain score changed in the diclofenac group compared with the pattern in the ofloxacin-treated eye; this change was not seen in the patients who received ketorolac. Neither NSAID affected visual outcomes.

To read an abstract of the study, visit the journal's website here.