Comparison of Pain After Photorefractive Keratectomy Using Preemptive Analgesia of 2 Kinds of NSAID

Friday, April 17, 2015
KIOSKS (San Diego Convention Center)
Byoung Jin Ha, MD
Jae Lim Chung, MD, MBA
David Sung Yong Kang, MD
Jin Young Choi, MD
Eun Kyung Kim, MD

Purpose
To evaluate relative pain using the Vision Analogue Scale (VAS) after pre-emptive analgesia with 2 different types of Non-steroidal anti-inflammatory drugs(NSAIDS); Bromfenac(0.1%, Taejun, Korea.) and Diclofenac(0.1%, Novartis,USA).

Methods
356 Eyes of 178 patients were randomly assigned to a paired-eye regimen of pre-emptive analgesia; 0.1% Diclofenac to one eye and 0.1% Bromfenac to the other eye. One drop of each drug was applied 3 times to each eye at 20 minute intervals 1 hour prior to surgery and 1 extra drop immediately before epithelial removal. Patients were asked to score postoperative pain in each eye with a visual analog scale at 6, 18, 24, 36, 48, 72, and 96 hours. Paired sample t-test was used for statistical analysis.

Results
Pain scores for diclofenac and bromfenac (mean±SD) were 1.0±1.1 versus 1.0±1.0 (p=0.87) for the day of surgery, 2.8±1.9 versus 2.5±1.7 (p=0.11) at post-operative day 1, 3.5±1.6 versus 3.0±1.3 (p=0.02) for post-operative day 2, 1.4±1.1 versus 1.3±0.8 (p=0.51) for post-operative day 3 and 0.4±0.6 versus 0.3±0.5 (p=0.26) for post-operative day 4, respectively.

Conclusion
Pre-emptive analgesia with 0.1% Diclofenac and 0.1% Bromfenac showed no significant differences in post-operative pain except for post-operative day 2, when Bromfenac showed less pain. Topical Bromfenac may be considered as an alternative to Diclofenac for pre-emptive analgesia before PRK.