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Pain management after photorefractive keratectomy
Rohit Shetty1, Ritika Dalal1, Archana Padmanabhan Nair2
1Narayana Nethralaya Superspeciality Eye Hospital and the Postgraduate Institute of Ophthalmology, Bangalore, India.
Journal of Cataract and Refractive Surgery
|April 29, 2019
Summary
Ketorolac-soaked bandage contact lenses significantly reduced pain after transepithelial photorefractive keratectomy (PRK). This method provides effective postoperative pain relief by acting as a drug depot, without adverse events.
Area of Science:
- Ophthalmology
- Pharmacology
- Surgical Innovation
Background:
- Transepithelial photorefractive keratectomy (PRK) is a common refractive surgery.
- Postoperative pain management remains a critical aspect of patient recovery after PRK.
Purpose of the Study:
- To evaluate the efficacy of a bandage contact lens soaked in ketorolac ophthalmic 0.45% solution in modulating pain following transepithelial PRK.
- To assess the safety and drug release profile of ketorolac-soaked bandage contact lenses.
Main Methods:
- A prospective case series involving two groups of patients undergoing transepithelial PRK.
- One group received a standard bandage contact lens, while the other received a ketorolac-soaked bandage contact lens.
- Pain was assessed using the Wong-Baker pain scale, and drug elution was analyzed using ultra-high-performance liquid chromatography (UHPLC).
Main Results:
- Patients receiving the ketorolac-soaked bandage contact lens reported significantly lower mean pain scores (2.76 ± 0.85) compared to the control group (7.95 ± 2.12).
- UHPLC analysis confirmed that the soaked bandage contact lens functions as a drug depot, releasing ketorolac onto the ocular surface over time.
- No adverse events were reported with the use of the ketorolac-soaked bandage contact lens.
Conclusions:
- A bandage contact lens soaked in ketorolac 0.45% solution is an effective method for reducing postoperative pain after transepithelial PRK.
- This approach utilizes the bandage contact lens as a sustained-release drug delivery system for enhanced pain management.
- The ketorolac-soaked bandage contact lens offers a safe and beneficial option for improving patient comfort post-PRK.
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