USE OF TOPICAL NONSTEROIDAL ANTIINFLAMMATORY DRUGS IN EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY

Nonsteroidal anti-inflammatory drugs (NSAIDs) produce potent analgesic , antipyretic, and anti-inflammatory effects. We studied postoperative pain in 97 consecutive patients having photorefractive keratectomy (P RK) by an excimer laser with different topical NSAID protocols. Treatm ent with topical homatropine hydrobromide, either diclofenac sodium (V oltaren Ophthalmic(R)) or ketorolac tromethamine (Acular(R)), and a so ft contact lens was most effective in achieving post-PRK analgesia. We also studied post-PRK myopic regression in 68 consecutive patients an d found that flurbiprofen sodium (Ocufen(R)), when added to topical st eroid protocols, significantly reduced myopic regression for one year postoperatively more than steroids alone or steroids and diclofenac so dium. Diclofenac, used with topical steroids, had less of an additive effect on myopic regression than did flurbiprofen. Topical NSAIDs are useful adjuncts to PRK therapy, both to eliminate postoperative pain a nd to control post-PRK myopic regression.