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Comparison of analgesic effect of preoperative topical diclofenac and ketorolac on postoperative pain after photorefractive keratectomy

Authors
 Jin Pyo Hong  ;  Sang Min Nam  ;  Chan Young Im  ;  Sangchul Yoon  ;  Taeim Kim  ;  Eung Kweon Kim  ;  Kyoung Yul Seo 
Citation
 JOURNAL OF CATARACT AND REFRACTIVE SURGERY, Vol.40(10) : 1689-1696, 2014 
Journal Title
 JOURNAL OF CATARACT AND REFRACTIVE SURGERY 
ISSN
 0886-3350 
Issue Date
2014
MeSH
Administration, Topical ; Adult ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use* ; Corneal Stroma/surgery ; Diclofenac/adverse effects ; Diclofenac/therapeutic use* ; Double-Blind Method ; Eye Pain/drug therapy* ; Female ; Humans ; Ketorolac/adverse effects ; Ketorolac/therapeutic use* ; Male ; Myopia/surgery ; Ophthalmic Solutions ; Pain Measurement ; Pain, Postoperative/drug therapy* ; Photorefractive Keratectomy* ; Visual Acuity/drug effects ; Young Adult
Abstract
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S088633501400707X
DOI
10.1016/j.jcrs.2014.05.029
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Eung Kweon(김응권) ORCID logo https://orcid.org/0000-0002-1453-8042
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyuong Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
Yoon, Sang Chul(윤상철) ORCID logo https://orcid.org/0000-0003-0454-9597
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/138808
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