A PROSPECTIVE RANDOMIZED TRIAL OF TROPICAL SOLUBLE 0.1-PERCENT INDOMETHACIN VERSUS 0.1-PERCENT DICLOFENAC VERSUS PLACEBO FOR THE CONTROL OFPAIN FOLLOWING EXCIMER-LASER PHOTOREFRACTIVE KERATECTOMY

BACKGROUND AND OBJECTIVE: To compare the safety and efficacy of topica l nonsteroidal antiinflammatory drugs (NSAIDs) for the control of pain after excimer laser photorefractive keratectomy (PRK). PATIENTS AND M ETHODS: One hundred twenty informed patients were enrolled in a double -masked, randomized, comparative study and assigned to either 0.1% ind omethacin, 0.1% diclofenac, or placebo treatment. Subjective postopera tive pain, symptoms, re-epithelialization rate, and systemic medicatio ns were monitored for 2 days following photoablation. RESULTS: Compare d with the placebo, 0.1% indomethacin solution significantly reduced p ain on the day of surgery (D0) (P < .05), whereas 0.1% diclofenac did not reach a significant level (P = .46). At D0, analgesic intake by th e oral route was significantly greater in the placebo group (P < .05). Severe photophobia was significantly less frequent in the group treat ed with 0.1% indomethacin (P < .05). Corneal wound healing was signifi cantly delayed in the patients treated with 0.1% diclofenac at D2 as c ompared with other groups (P = .04). CONCLUSION: Topical 0.1% indometh acin solution helps control the pain induced by excimer laser photoabl ation of the cornea without any detrimental effect to the corneal epit helial wound healing.