title: Efficacy and safety of pain relief medications after photorefractive keratectomy: review of prospective randomized trials.
abstract: The objective of this review was to provide a comprehensive overview and comparison of results from all prospective randomized trials published to date of medications used to treat pain after photorefrative keratectomy (PRK). A PubMed database search revealed 23 prospective and randomized studies. They included the following classes of medications: nonsteroidal antiimflammatory drugs (NSAIDs), anesthetics, opiates, acetaminophen, gabapentin, and pregabalin. The studies found that although the efficacy of drugs tended to be similar, tetracaine 1% and nepafenac 0.1% tended to have the most analgesic effect. Delayed corneal reepithelialization was a common side effect of both topical anesthetics and topical NSAIDs. Tetracaine 1% resulted in the most significant delay in reepithelialization when tested against placebo control compared with other topical medications tested against placebo. Concomitant use of topical NSAIDs and topical anesthetics, especially tetracaine, may have to be avoided to minimize the risk for delayed corneal healing.
  
  
  BACKGROUND
  Neither author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: From the Refractive and Corneal Surgery, Pacific Vision Institute, San Francisco, California, USA. Electronic address: ella@pacificvision.org.
authors.forename: Ella G
authors.initials: EG
authors.lastname: Faktorovich
authors.affiliation: From the Refractive and Corneal Surgery, Pacific Vision Institute, San Francisco, California, USA.
authors.forename: Karishma
authors.initials: K
authors.lastname: Melwani
mesh_terms: D000588:Amines / Q000009:adverse effects / Q000627:therapeutic use; D000700:Analgesics / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects / Q000627:therapeutic use; D058447:Eye Pain / Q000188:drug therapy*; D000077206:Gabapentin; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy*; D018903:Photorefractive Keratectomy; D000069583:Pregabalin; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin