"Pain Management In Photorefractive Keratectomy: A Mini Review"
Published 2025 - 43rd Congress of the ESCRS
Reference: PO779 | Type: Free paper | DOI: 10.82333/4t0h-5b73
Authors: Kevin Waquim Carvalho* 1 , Arthur Gustavo Fernandes 2 , Diego Casagrande 1 , Marcos Cohen 3 , Jacob Cohen 3 , Paula Marinho 4 , Ariane Anders 5 , Beatriz Stauber 2 , Nivea Ferraz 2 , Adriana Berezovsky 2 , Solange Salomão 2 , Rubens Belfort Junior 4
1Instituto da Visão – IPEPO,SÃO PAULO,Brazil, 2Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Universidade Federal de São Paulo – Unifesp,SÃO PAULO,Brazil, 3Ophthalmology Division, Universidade Federal do Amazonas,Manaus,Brazil, 4Instituto da Visão – IPEPO,SÃO PAULO,Brazil;Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Universidade Federal de São Paulo – Unifesp,SÃO PAULO,Brazil, 5Department of Ophthalmology and Visual Science, Escola Paulista de Medicina, Universidade Federal de São Paulo – Unifesp,SÃO PAULO,Brazil;Pontifica Universidad Católica de Valparaíso,valparaíso,Chile
Purpose
Photorefractive keratectomy (PRK) is a widely used laser technique in refractive surgery, offering long-term efficacy and serving as an excellent alternative to LASIK for patients with thin corneas, irregular corneas, or high risk of eye trauma .
PRK involves removing the corneal epithelium and reshaping the stroma with an excimer laser, avoiding flap-related complications .
However, PRK is associated with a longer recovery and significant postoperative pain, which remains a big inconvenience for patients. Effective pain management is crucial for improving comfort and outcomes. This mini-review explores strategies, including pharmacological, non-pharmacological, and emerging techniques, for managing post-PRK pain.
Setting
This mini-review summarizes current and recent literature on post-PRK pain management, drawing from studies conducted in various countries and across different age groups. This diversity ensures the findings are not limited to a specific population, making the review broadly applicable. Most of the studies are evidence-based, including meta-analyses, and systematic reviews.The review also highlights the emerging techniques in post-PRK pain management that have been tested and reported to date.
Methods
This mini-review analyzes literature (2010–2024) on post-PRK pain management. A systematic search used PubMed and Google Scholar, with keywords like "post-PRK pain" and "emerging therapies." Included studies were RCTs, meta-analyses, or clinical trials; irrelevant articles were excluded. Over 200 articles were screened, with 56 meeting inclusion criteria. These were analyzed for methods, outcomes, and contributions. Emerging therapies from recent trials were also reviewed. Data were synthesized thematically to provide a comprehensive overview of post-PRK pain management.
Results
The review highlights diverse approaches for post-PRK pain management. Topical NSAIDs (e.g., ketorolac) and corticosteroids reduce inflammation but may cause side effects. Oral medications like ibuprofen provide mild relief, while opioids are limited due to dependency risks. Non-pharmacological methods, such as bandage contact lenses and cold compresses, enhance comfort and healing. Emerging therapies like photobiomodulation and regenerative techniques show promise. Combining methods (e.g., NSAIDs + BCLs) offers the best outcomes. While traditional treatments remain effective, further research is needed to optimize emerging strategies.
Conclusions
PRK surgery is a widely used vision correction procedure with long-term benefits, but postoperative pain remains a major challenge. Various strategies, such as topical medications, bandage contact lenses, and emerging regenerative therapies, have been developed to manage discomfort. Combining these approaches enhances pain relief and improves patient recovery. However, there is still room for advancement, highlighting the need for ongoing research to develop more effective and comfortable treatment options.