Effect Of A Single Drop Of 0.3% Nepafenac Ophthalmic Suspension On Postoperative Pain After Photorefractive Keratectomy

To investigate the effect of a single drop of 0.3% nepafenac administered immediately before therapeutic contact lens (TCL) placement on postoperative pain following photorefractive keratectomy (PRK).

This prospective, randomized, contralateral eye study included 56 eyes of 28 patients (11 males, 17 females) who underwent PRK for low-to-moderate myopia and myopic astigmatism correction. One eye was randomly assigned to receive a single drop of 0.3% nepafenac ophthalmic suspension immediately before therapeutic contact lens (TCL) placement post-ablation (Group-1), while the fellow eye (Group-2) did not receive the drop. Postoperative pain was assessed using a 0–10 scale on the day of surgery and at the same time each day for four days. Preoperative visual acuity, refractive values, corneal topographic data, intraoperative optic zone, total ablation zone, and mitomycin-C (MMC) application times were also analyzed.

The mean age of patients was 25.44 ± 4.36 years (21–35). No significant differences were found between the groups in terms of thinnest or central corneal thickness (TCT)(CCT), corneal volume (CV), flat (K1) and steep (K2) keratometry, preoperative uncorrected and corrected distance visual acuity (UDVA) (CDVA), spherical and cylindrical values, intraoperative OZ, TAD, or MMC application time (each p>0.05). Although pain scores were lower in Group-1 at all time points, the differences were not statistically significant (each p>0.05). Pain scores significantly decreased from day 0 to day 4 in both groups (each p<0.05). No significant correlations were found between pain scores and TCT, CCT, OZ, TAD, or MMC application time (each p>0.05).

The administration of a single drop of 0.3% nepafenac immediately after PRK did not result in a statistically significant reduction in postoperative pain compared to the control group. However, pain scores were consistently lower in the nepafenac-treated eyes at all time points. Both groups demonstrated a significant decrease in pain over the four-day postoperative period. Further studies with larger sample sizes are needed to determine the potential benefits of preemptive nepafenac use in PRK pain management.