ESCRS - POREF229 - Pain Control Following Transepithelial Photorefractive Keratectomy: A Randomized Controlled Trial Of Adding Preoperative Topical Prednisolone To Bromfenac.

Pain Control Following Transepithelial Photorefractive Keratectomy: A Randomized Controlled Trial Of Adding Preoperative Topical Prednisolone To Bromfenac.

Published 2026 - 44th Congress of the ESCRS

Reference: POREF229 | Type: Free paper | DOI: 10.82333/2f7x-8w03

Authors: Dr Ali Nowrouzi* 1 , Dr Francesco D’Oria 2 , Dr Nabil Ragaei Kamel 3 , A/Prof. Jorge L. Alió 4

1Ophthalmology,Hospital Quironsalud Marbella ,Marbella,Spain, 2Department of Translational Biomedicine and Neuroscience,University of Bari,Bari,Italy, 31. Department of Ophthalmology, ,Hospital Quironsalud Marbella.,Marbella,Spain, 44. Department of Ophthalmology,Universidad Miguel Hernández,Alicante,Spain

Purpose

To evaluate whether the addition of preoperative topical prednisolone acetate to bromfenac reduces early postoperative pain following transepithelial photorefractive keratectomy (Trans-PRK).

Setting

Cornea and refractive surgery department of Quironsalud Hospital, Marbella, Spain.

Methods

One eye per patient
 

was included for analysis to avoid inter-eye correlation. Group 1 received preoperative bromfenac 0.09% three times daily for 3 days before surgery. Group 2 received the same regimen plus preoperative prednisolone acetate 1% three times daily for 3 days. Postoperative pain was assessed using a numerical rating scale (NRS; 0–10) on postoperative Days 1 and 2.

 
Rescue analgesia (ibuprofen 600 mg plus codeine 30 mg) was permitted and recorded

. Secondary outcomes included visual acuity, refractive stability, epithelial healing, and complications over 6 months.

Results

Group 2 demonstrated significantly lower pain scores than Group 1 on Day 1 (3.2 ± 1.6 vs 6.5 ± 1.8;p< 0.0001) and Day 2 (1.52 ± 1.2 vs 4.50 ± 2.7;p< 0.0001). The mean number of rescue analgesic doses was lower in Group 2 (1 ± 1) versus Group 1 (3 ± 1) (mean difference −2 doses; 95% CI −2.6 to −1.4; p < 0.001), and rescue medication was required by 35% versus 80% of patients, respectively.

Conclusions

Adding preoperative prednisolone acetate to bromfenac significantly reduces early postoperative pain after Trans-PRK without compromising safety or visual outcomes. This adjunctive strategy may enhance patient comfort.