Analgesic Effect of Topical Nepafenac 0.1% on Pain Related to Intravitreal Injections: A Randomized Crossover Study

To evaluate the analgesic effect of nepafenac 0.1%, a topical non-steroidal anti-inflammatory agent, in patients undergoing treatment with intravitreal injections (IVIs).

It is a single center, prospective, randomized, double-blinded, placebo-controlled, crossover interventional study. Fifty-two patients scheduled to undergo IVI of anti-vascular endothelial growth factors were included in the study. Patients were randomized in a 1:1 ratio to receive topical nepafenac 0.1% or placebo 1 h before subsequent IVIs. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the Visual Analogue Scale (VAS), the Main Component of the SF-MPQ (MC-SF-MPQ), and the Present Pain Intensity (PPI) scores immediately and 6-h post-injection.

The VAS pain score was statistically significant lower immediately and 6-h post-IVI in patients treated with nepafenac (p = 0.001 and < 0.001, respectively). The MC-SF-MPQ scores were also statistically significant lower after nepafenac administration at both time points (p < 0.001). Finally, the PPI score was statistically significant lower when nepafenac was instilled before IVI (p = 0.015 immediately and p < 0.001 at 6-h post-injection).

A single drop of nepafenac 0.1% before IVI could effectively alleviate the IVI-related pain immediately and up to 6 h after the injection.