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