Assessment of subjective pain following photorefractive keratectomy. Melbourne Excimer Laser Group.
BACKGROUND
Although researchers have reported that postoperative pain in patients undergoing excimer laser photorefractive keratectomy (PRK) surgery is common in the first 24 hours after excimer surgery, factors associated with increased postoperative pain have not been reported. The purpose of this study was to prospectively document self-reported pain following excimer laser surgery and explore associated factors.


METHODS
Consecutive patients undergoing excimer laser photorefractive keratectomy (PRK) surgery to correct myopia and/or myopic astigmatism were asked to prospectively grade, on a four-point scale, the amount of pain they were experiencing immediately after treatment and again 2, 4, 8, 24, and 48 hours after surgery. They were also asked to record the type and dose of all medication taken during that time period.


RESULTS
Pain questionnaires were returned by 62 patients (72%), ranging in age from 20 to 54 years. The mean self-reported pain overall peaked 24 hours after treatment. Amount of myopia and prior excimer experience were not related to use of analgesia or self-reported pain (both p > 0.10). Patients who had three additional topical drops of indomethacin postoperatively reported significantly less pain 24 hours after treatment (t = 5.95, p = 0.0001).


CONCLUSIONS
These results have implications for the education of patients about the likely course of healing after PRK. A course of five drops of topical indomethacin should be evaluated with a randomized clinical trial to assess efficacy in inhibiting ocular pain after PRK.
McCarty
C A
CA
University of Melbourne, Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia.
Garrett
S K
SK
Aldred
G F
GF
Taylor
H R
HR
D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007213:Indomethacin / Q000008:administration & dosage; D054018:Lasers, Excimer; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000503:physiopathology*; D018903:Photorefractive Keratectomy; D011795:Surveys and Questionnaires; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007213:Indomethacin