Posters

Effect of naproxen, prednisolone and ketorolac on post photorefractive keratectomy pain management

Poster Details

First Author: M.Abrishami IRAN

Co Author(s):    S. Zarei-Ghanavati   A. Eslampour   M. Abrishami   S. Hasanzadeh           

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, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

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 Prednisiolone, and (5) topical Ketorolac and oral Naproxen. The patients were asked to subjectively assess ophthalmic indices consisting pain (severity score: 0-10), photophobia (quantitative severity score: 0-4), and functional activity (severity score: 1-3). Surgeons were asked to objectively assess and report eyelid edema (severity score: 0-3) and conjunctival injection (severity score: 0-4). The results were compared between 5 post- operative therapeutic regimens.

Results:

We enrolled one-hundred forty four cases. In post-operative 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 limitation in functional activities by pain was not significantly different.Objective evaluation of post-PRK ocular features showed a significant difference in severity score of eyelid edema between 5 groups of study (p<0.001). 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:

We found that oral prednisolone was inferior to other regimes in controlling pain and regimes containing topical NSAID, ketorolac, were superior. In eyelid edema, topical or systemic NSAIDs were effective, and the regime contained both topical and systemic, had the least eyelid edema. In conjunctival edema, again ketorolac showed to be superior.

Financial Disclosure:

None