Double-masked study of the effects of nepafenac 0.1% and ketorolac 0.4% on corneal epithelial wound healing and pain after photorefractive keratectomy |
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Authors: | Eric D Donnenfeld Edward J Holland Daniel S Durrie Michael B Raizman |
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Institution: | (1) Ophthalmic Consultants of Long Island 2000, North Village Ave., 11570 Rockville Centre, NY;(2) Cincinnati Eye, Edgewood, Kentucky;(3) Durrie Vision, Overland Park, Kansas;(4) Ophthalmic Consultants of Boston, Boston, Massachusetts |
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Abstract: | Two NSAIDs—nepafenac 0.1% and ketorolac tromethamine 0.4%—were compared in terms of their effects on corneal reepithelialization
and pain after photorefractive keratectomy (PRK) in a randomized, double-masked, contralateral eye, multicenter study. A total
of 40 healthy adult patients who were undergoing sequential bilateral PRK received nepafenac 0.1% and ketorolac 0.4% in contralateral
eyes, 1 drop 3 times daily for 3 d after bandage contact lens insertion. Patients were assessed on postoperative days 1, 3,
4, 5, and 7. At each visit, patients provided a general rating of pain. Each patient also assessed the sensation of each eyedrop
following instillation (after-drop pain, irritation, burning/stinging, and overall comfort). Starting on day 3, epithelial
defect size was assessed. Mean epithelial defect size was similar between treatments at each postoperative visit (P > .05). The average time-to-healing was 4.18 d for nepafenac 0.1 % and 4.00 d for ketorolac 0.4% (P=.3134). No statistical difference was observed between nepafenac 0.1% and ketorolac 0.4% in mean postoperative pain scores
(P > .05). On day 3, the nepafenac 0.1% group had significantly lower mean sensation scores than did the ketorolac 0.4% group
for after-drop pain (P=.0090), irritation (P=.0007), and burning/ stinging (P=.0003). Mean overall comfort score was also significantly better for nepafenac 0.1% on day 3 (7.43 vs 6.41; P < .0001). Nepafenac
0.1% and ketorolac 0.4% provide postoperative pain relief after PRK surgery without associated adverse effects on corneal
epithelial healing. Nepafenac 0.1 % treatment may offer greater comfort upon instillation in patients who have undergone PRK. |
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Keywords: | photorefractive keratectomy PRK pain epithelial healing nepafenac ketorolac |
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