Preemptive analgesic effect of topical NSAIDs in postoperative pain relief after LASEK

Abstract

The aim of the study was to assess preemptive analgesic effect of topical NSAIDs (0.5% ketorolac tromethamine) on postoperative pain relief in patients undergoing LASEK and to examine the effect of topical NSAIDs on normal corneal sensation using corneal sensitivity test. In part 1, patients undergoing LASEK were randomized to receive 0.5% ketorolac in one eye and 0.3% ofloxacin (placebo) in the contralateral eye at 30, 20 and 10 minutes prior to LASEK. Postoperative pain and the levels of glare, tearing and irritation were assessed using a visual analog scale. A total of 62 eyes from 31 patients were enrolled. The mean postoperative pain score in the NSAID-pretreated eye was significantly lower than that in the placebo-received eye at postoperative hours 6, 12 and 24 (p<0.05). In part 2, ten subjects (Group 1) were randomized to instill 0.5% ketorolac in one eye and 0.3% ofloxacin (placebo) in the contralateral eye at every 10 minutes for 3 times. Another ten subjects (Group 2) were randomized to instill 0.5% ketorolac in one eye and 0.3% ofloxacin (placebo) in the contralateral eye at every 10 minutes for 3 times. After 10 minutes, 0.5% proparacaine was applied to both eyes. After 1, 2, and 6 hours, corneal sensitivity was measured. The mean corneal sensitivity was significantly lower in topical ketorolac-instilled eye than that of placebo-instilled eye for 2 hours after administration in both groups (p<0.05). Preemptive administration of topical NSAIDs before LASEK was effective in reducing acute postoperative pain.