ASSESSMENT OF SUBJECTIVE PAIN FOLLOWING PHOTOREFRACTIVE KERATECTOMY

BACKGROUND: Although researchers have reported that postoperative pain in patients undergoing excimer laser photorefractive keratectomy (PRK ) surgery is common in the first 24 hours after excimer surgery, facto rs associated with increased postoperative pain have not been reported . The purpose of this study was to prospectively document self-reporte d pain following excimer laser surgery and explore associated factors. METHODS: Consecutive patients undergoing excimer laser photorefractiv e keratectomy (PRK) surgery to correct myopia and/or myopic astigmatis m were asked to prospectively grade, on a four-point scale, the amount of pain they were experiencing immediately after treatment and again 2, 4, 8, 24, and 48 hours after surgery. They were also asked to recor d the type and dose of all medication taken during that time period, R ESULTS: Pain questionnaires were returned by 62 patients (72%), rangin g in age from 20 to 54 years. The mean self-reported pain overall peak ed 24 hours after treatment. Amount of myopia and prior excimer experi ence were not related to use of analgesia or self-reported pain (both p>0.10). Patients who had three additional topical drops of indomethac in postoperatively reported significantly less pain 24 hours after tre atment (t=5.95, p=0.0001). CONCLUSION: These results have implications for the education of patients about the likely course of healing afte r PRK. A course of five drops of topical indomethacin should be evalua ted with a randomized clinical trial to assess efficacy in inhibiting ocular pain after PRK.