title: Comparison of analgesic effect of preoperative topical diclofenac and ketorolac on postoperative pain after photorefractive keratectomy.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Saeyan Eye Center, Seoul, South Korea.
  
  
  METHODS
  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.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Jin Pyo
authors: JP
authors: Hong
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Sang Min
authors: SM
authors: Nam
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Chan Young
authors: CY
authors: Im
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Sangchul
authors: S
authors: Yoon
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Tae-Im
authors: TI
authors: Kim
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
authors: Eung Kweon
authors: EK
authors: Kim
authors: From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea. Electronic address: seoky@yuhs.ac.
authors: Kyoung Yul
authors: KY
authors: Seo
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D003319:Corneal Stroma / Q000601:surgery; D004008:Diclofenac / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D058447:Eye Pain / Q000188:drug therapy*; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009216:Myopia / Q000601:surgery; D009883:Ophthalmic Solutions; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D018903:Photorefractive Keratectomy; D014792:Visual Acuity / Q000187:drug effects; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D009883:Ophthalmic Solutions; D004008:Diclofenac; D020910:Ketorolac