Pain reduction after laser in situ keratomileusis with ketorolac tromethamine ophthalmic solution 0.5%: a randomized, double-masked, placebo-controlled trial.
OBJECTIVE
To evaluate the analgesic efficacy of ketorolac tromethamine ophthalmic solution 0.5% after laser in situ keratomileusis (LASIK).


METHODS
In this two-center, randomized, double-masked, placebo-controlled, parallel group study, 39 patients underwent bilateral simultaneous LASIK. Patients received study drops (Acular PF or Lens Plus) in both eyes 15 to 30 minutes before surgery, again immediately before passing of the microkeratome, and again after flap repositioning. Proparacaine was used during surgery, but no additional therapeutics were used for the next 24 hours, except acetaminophen or propoxyphene napsylate acetaminophen allowed as escape medication. Patients rated their eye pain hourly through 6 hours after surgery.


RESULTS
Ketorolac significantly reduced eye pain at every time point compared to placebo (P<.01). Escape medication use declined significantly; 16% (3/19) of those who received ketorolac required escape medication compared to 50% (8/16) of placebo-treated patients (P=.03). Ketorolac-treated eyes were pain-free significantly sooner (P<.01), with 47% (18/38) having pain cessation by hour 4, compared to 15% (5/33) of placebo-treated eyes. No treatment-related adverse events occurred.


CONCLUSIONS
This study supports the use of topical ketorolac for control of early postoperative pain following LASIK, significantly increasing patient comfort and reducing usage of other pain medications.
Price
Francis W
FW
Price Vision Group, Indianapolis, IN, USA. fprice@visiongroup.net
Price
Marianne O
MO
Zeh
William
W
Dobbins
Kendall
K
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D001251:Astigmatism / Q000601:surgery; D003315:Cornea / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ / Q000009:adverse effects*; D020911:Ketorolac Tromethamine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009216:Myopia / Q000601:surgery; D009883:Ophthalmic Solutions; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D020911:Ketorolac Tromethamine