Analgesic effect of preoperative topical nonsteroidal antiinflammatory drugs on postoperative pain after laser-assisted subepithelial keratectomy

Se Kyung Kim, Jin Pyo Hong, Sang Min Nam, Robert Doyle Stulting, KyoungYul Seo

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose To assess the effect of preoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) on postoperative pain after laser-assisted subepithelial keratectomy (LASEK) and to investigate their mechanism. Setting Severance Eye Hospital and Saeyan Eye Clinic, Seoul, South Korea. Design Prospective randomized clinical trial. Methods Participants in 2 related studies were assessed. Study 1 comprised patients scheduled for bilateral LASEK (Group 1) who were randomized to receive an NSAID in 1 eye and a placebo in the fellow eye 30, 20, and 10 minutes before LASEK. Postoperative pain, glare, tearing, and irritation were assessed using a visual analog scale. Study 2 comprised healthy subjects (Group 2) who were randomly divided into subgroups. The participants in these subgroups were randomized to receive ketorolac tromethamine 0.5% in 1 eye and placebo (ofloxacin 0.3%) in the fellow eye (Group 2A), proparacaine hydrochloride 0.5% in 1 eye and placebo in the fellow eye (Group 2B), or ketorolac tromethamine 0.5% in 1 eye and placebo in the fellow eye, followed 10 minutes later by 1 drop of proparacaine hydrochloride 0.5% in both eyes (Group 2C). In all 3 groups, corneal sensitivity was measured after 1, 2, and 6 hours. Results The mean postoperative pain score in the NSAID-pretreated eye was statistically significantly lower than in the placebo-pretreated eye 6, 12, and 24 hours postoperatively (P <.05). The mean corneal sensitivity was statistically significantly lower in the NSAID-treated eye than in the placebo-treated eye at 1 and 2 hours in Groups 2A and 2C (P <.05). Conclusion Preoperative administration of topical NSAIDs before LASEK effectively reduces postoperative pain. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

Original languageEnglish
Pages (from-to)749-755
Number of pages7
JournalJournal of Cataract and Refractive Surgery
Volume41
Issue number4
DOIs
Publication statusPublished - 2015 Jan 1

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Laser-Assisted Subepithelial Keratectomy
Postoperative Pain
Analgesics
Anti-Inflammatory Agents
Pharmaceutical Preparations
Placebos
Ketorolac Tromethamine
Glare
Topical Administration

All Science Journal Classification (ASJC) codes

  • Surgery
  • Ophthalmology
  • Sensory Systems

Cite this

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title = "Analgesic effect of preoperative topical nonsteroidal antiinflammatory drugs on postoperative pain after laser-assisted subepithelial keratectomy",
abstract = "Purpose To assess the effect of preoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) on postoperative pain after laser-assisted subepithelial keratectomy (LASEK) and to investigate their mechanism. Setting Severance Eye Hospital and Saeyan Eye Clinic, Seoul, South Korea. Design Prospective randomized clinical trial. Methods Participants in 2 related studies were assessed. Study 1 comprised patients scheduled for bilateral LASEK (Group 1) who were randomized to receive an NSAID in 1 eye and a placebo in the fellow eye 30, 20, and 10 minutes before LASEK. Postoperative pain, glare, tearing, and irritation were assessed using a visual analog scale. Study 2 comprised healthy subjects (Group 2) who were randomly divided into subgroups. The participants in these subgroups were randomized to receive ketorolac tromethamine 0.5{\%} in 1 eye and placebo (ofloxacin 0.3{\%}) in the fellow eye (Group 2A), proparacaine hydrochloride 0.5{\%} in 1 eye and placebo in the fellow eye (Group 2B), or ketorolac tromethamine 0.5{\%} in 1 eye and placebo in the fellow eye, followed 10 minutes later by 1 drop of proparacaine hydrochloride 0.5{\%} in both eyes (Group 2C). In all 3 groups, corneal sensitivity was measured after 1, 2, and 6 hours. Results The mean postoperative pain score in the NSAID-pretreated eye was statistically significantly lower than in the placebo-pretreated eye 6, 12, and 24 hours postoperatively (P <.05). The mean corneal sensitivity was statistically significantly lower in the NSAID-treated eye than in the placebo-treated eye at 1 and 2 hours in Groups 2A and 2C (P <.05). Conclusion Preoperative administration of topical NSAIDs before LASEK effectively reduces postoperative pain. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.",
author = "Kim, {Se Kyung} and Hong, {Jin Pyo} and Nam, {Sang Min} and Stulting, {Robert Doyle} and KyoungYul Seo",
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Analgesic effect of preoperative topical nonsteroidal antiinflammatory drugs on postoperative pain after laser-assisted subepithelial keratectomy. / Kim, Se Kyung; Hong, Jin Pyo; Nam, Sang Min; Stulting, Robert Doyle; Seo, KyoungYul.

In: Journal of Cataract and Refractive Surgery, Vol. 41, No. 4, 01.01.2015, p. 749-755.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Analgesic effect of preoperative topical nonsteroidal antiinflammatory drugs on postoperative pain after laser-assisted subepithelial keratectomy

AU - Kim, Se Kyung

AU - Hong, Jin Pyo

AU - Nam, Sang Min

AU - Stulting, Robert Doyle

AU - Seo, KyoungYul

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N2 - Purpose To assess the effect of preoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) on postoperative pain after laser-assisted subepithelial keratectomy (LASEK) and to investigate their mechanism. Setting Severance Eye Hospital and Saeyan Eye Clinic, Seoul, South Korea. Design Prospective randomized clinical trial. Methods Participants in 2 related studies were assessed. Study 1 comprised patients scheduled for bilateral LASEK (Group 1) who were randomized to receive an NSAID in 1 eye and a placebo in the fellow eye 30, 20, and 10 minutes before LASEK. Postoperative pain, glare, tearing, and irritation were assessed using a visual analog scale. Study 2 comprised healthy subjects (Group 2) who were randomly divided into subgroups. The participants in these subgroups were randomized to receive ketorolac tromethamine 0.5% in 1 eye and placebo (ofloxacin 0.3%) in the fellow eye (Group 2A), proparacaine hydrochloride 0.5% in 1 eye and placebo in the fellow eye (Group 2B), or ketorolac tromethamine 0.5% in 1 eye and placebo in the fellow eye, followed 10 minutes later by 1 drop of proparacaine hydrochloride 0.5% in both eyes (Group 2C). In all 3 groups, corneal sensitivity was measured after 1, 2, and 6 hours. Results The mean postoperative pain score in the NSAID-pretreated eye was statistically significantly lower than in the placebo-pretreated eye 6, 12, and 24 hours postoperatively (P <.05). The mean corneal sensitivity was statistically significantly lower in the NSAID-treated eye than in the placebo-treated eye at 1 and 2 hours in Groups 2A and 2C (P <.05). Conclusion Preoperative administration of topical NSAIDs before LASEK effectively reduces postoperative pain. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

AB - Purpose To assess the effect of preoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) on postoperative pain after laser-assisted subepithelial keratectomy (LASEK) and to investigate their mechanism. Setting Severance Eye Hospital and Saeyan Eye Clinic, Seoul, South Korea. Design Prospective randomized clinical trial. Methods Participants in 2 related studies were assessed. Study 1 comprised patients scheduled for bilateral LASEK (Group 1) who were randomized to receive an NSAID in 1 eye and a placebo in the fellow eye 30, 20, and 10 minutes before LASEK. Postoperative pain, glare, tearing, and irritation were assessed using a visual analog scale. Study 2 comprised healthy subjects (Group 2) who were randomly divided into subgroups. The participants in these subgroups were randomized to receive ketorolac tromethamine 0.5% in 1 eye and placebo (ofloxacin 0.3%) in the fellow eye (Group 2A), proparacaine hydrochloride 0.5% in 1 eye and placebo in the fellow eye (Group 2B), or ketorolac tromethamine 0.5% in 1 eye and placebo in the fellow eye, followed 10 minutes later by 1 drop of proparacaine hydrochloride 0.5% in both eyes (Group 2C). In all 3 groups, corneal sensitivity was measured after 1, 2, and 6 hours. Results The mean postoperative pain score in the NSAID-pretreated eye was statistically significantly lower than in the placebo-pretreated eye 6, 12, and 24 hours postoperatively (P <.05). The mean corneal sensitivity was statistically significantly lower in the NSAID-treated eye than in the placebo-treated eye at 1 and 2 hours in Groups 2A and 2C (P <.05). Conclusion Preoperative administration of topical NSAIDs before LASEK effectively reduces postoperative pain. Financial Disclosure No author has a financial or proprietary interest in any material or method mentioned.

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