Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial.
BACKGROUND
A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy.


METHODS
Prospective randomized, double-masked clinical trial applied in the Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.


METHODS
Sixty-eight individuals (age range, 18-35 years) having bilateral photorefractive keratectomy for myopic correction with or without astigmatism.


METHODS
All patients received 100 mg of extended-release oral diclofenac two times (12-h interval) before photorefractive keratectomy surgery. Postoperatively, patients were randomized into the case and control groups. Case group was administered the diclofenac 0.1% drop, one drop 2 h preoperatively and four times daily postoperatively for 3 days, whereas the control group was given artificial tears instead.


METHODS
Pain level, photophobia and functional activity were evaluated by the patient after operation.


RESULTS
Two days after surgery, no statistically significant difference in pain level was noted between both groups. In addition, photophobia and functional activity was not different between the case and control groups. Eyelid oedema and conjunctival injection levels were significantly higher in the control group (P < 0.001).


CONCLUSIONS
Administration of topical diclofenac to a standardized postoperative pain regime did not alleviate post-photorefractive keratectomy pain, although it is effective in local signs like eyelid oedema and conjunctival injection. It can be concluded that oral diclofenac is sufficient in the management of post-photorefractive keratectomy pain and addition of the topical diclofenac is unnecessary.
Cornea Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Tehran, Iran.
Alireza
A
Eslampoor
Asieh
A
Ehsaei
Mojtaba
M
Abrishami
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D004008:Diclofenac / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D058447:Eye Pain / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000601:surgery; D009883:Ophthalmic Solutions; D059408:Pain Management; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D018903:Photorefractive Keratectomy / Q000009:adverse effects*; D011446:Prospective Studies; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D004008:Diclofenac
cornea; diclofenac; pain; photorefractive keratectomy