Comparison of ketorolac tromethamine, diclofenac sodium, and moist drops for ocular pain after radial keratotomy.
OBJECTIVE
To compare the 2 most popular commercially available topical nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of ocular pain following radial keratotomy (RK).


METHODS
Multicenter clinical trial.


METHODS
Ninety-seven RK patients were randomly assigned to 1 of 3 treatment groups: ketorolac tromethamine, diclofenac sodium, and moist drops as a control. The patients used 1 drop of the masked medication and 1 drop of ofloxacin 3 times a day for 3 days prior to surgery. They received 1 drop of the masked medication 1 hour before surgery, immediately after surgery, and 4 times a day thereafter. Patients were given a written questionnaire preoperatively and were also instructed to call a central computerized telephone system to answer prerecorded questions about ocular comfort. The calls were placed 30 minutes and 1, 2, 3, 4, 5, 6, 24, and 48 hours after surgery.


RESULTS
Two hundred ten statistical values were calculated to compare symptoms in the unoperated eye at baseline with symptoms in the operated eyes at each of 9 postoperative time points. Only 7 of the 210 values (3.3%) were significantly different among patient groups (operated versus unoperated eyes) by psychometric testing.


CONCLUSIONS
Both ketorolac tromethamine and diclofenac sodium were more effective in reducing post-RK discomfort than the control (moist artificial tears). Given the large number of tests and the small number that tested as significant, the significant differences (7 of 210 measurements) observed among the 3 treatment groups probably occurred by chance, although the improved foreign-body sensation, functionality, and compliance scores in the ketorolac group during the first 4 hours might be clinically important.
McDonald
M B
MB
Tulane University, New Orleans, Louisiana, USA.
Brint
S F
SF
Caplan
D I
DI
Bourque
L B
LB
Shoaf
K
K
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007646:Keratotomy, Radial / Q000009:adverse effects*; D020911:Ketorolac Tromethamine; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014046:Tolmetin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014325:Tromethamine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014792:Visual Acuity
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D014325:Tromethamine; D004008:Diclofenac; D020911:Ketorolac Tromethamine; D014046:Tolmetin