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Effect of steroidal and non-steroidal drugs on post photorefractive keratectomy symptoms and signs

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First Author: A.Eslampoor IRAN

Co Author(s):    S. Zarei-Ghanavati   M. Abrishami   M. Abrishami   S. Hassanzadeh           

Abstract Details

Purpose:

To evaluate the effect of steroidal and non-steroidal anti-inflammatory drug (NSAID) agents on controlling post photorefractive keratectomy (PRK) pain, eyelid edema, conjunctival injection, photophobia, and limitation of functional activity.

Setting:

Khatam-al-Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.Prospective double-blind clinical trial

Methods:

Patients who were eligible candidates for PRK were enrolled in this double-blinded clinical trial. Patients were randomized to five post-operative therapeutic groups: (1) oral Naproxen (2) oral Prednisolone (3) topical Ketorolac (4) topical Ketorolac and oral Prednisolone, and (5) topical Ketorolac and oral Naproxen. The patients were asked to subjectively assess ophthalmic indices consisting of pain, photophobia, and functional activity. Surgeons were asked to objectively assess and report eyelid edema and conjunctival injection. The results were compared between 5 postoperative therapeutic regimens.

Results:

One hundred forty- four cases were enrolled. In post-operative subjective assessment, the mean perceived pain score in five groups of patients was significantly different (p= 0.034). Also difference in reported photophobia severity score was statistically significant between groups (p=0.028), but the limitation in functional activities by pain was not significantly different (p=0.317). Objective evaluation of post- PRK ocular features showed a significant difference in the severity score of eyelid edema between 5 groups of study (p<0.001). The severity score of conjunctival injection was not significantly different between patients with 5 post- PRK therapeutic regimens (p=0.074). All reported severity scores of ophthalmic indices were higher in participants who received oral Prednisolone.

Conclusions:

Although steroidal drugs could be comparable to NSAIDs in controlling inflammatory signs, NSAIDs may provide better control in pain management following photorefractive keratectomy.  

Financial Disclosure:

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