Pain Management in Corneal Collagen Crosslinking for Keratoconus: A Comparative Case Series

Area of Science:

• Ophthalmology
• Corneal Surgery
• Pain Management

Background:

• Corneal collagen crosslinking (CXL) is a surgical treatment for progressive keratoconus.
• Postoperative pain management is crucial for patient comfort and recovery after CXL.
• Evaluating effective analgesic options for CXL is important for clinical practice.

Purpose of the Study:

• To compare the efficacy of oral ketorolac versus gabapentin in managing postoperative pain following corneal collagen crosslinking (CXL).
• To assess eye symptoms and systemic adverse events associated with these oral medications after CXL.

Main Methods:

• A prospective, interventional, comparative case series was conducted.
• Patients undergoing epithelium-off (epi-off) or epithelium-on (epi-on) CXL were randomized to receive either oral ketorolac or gabapentin for three days post-surgery.
• Pain scores, eye symptoms, and systemic adverse events were assessed postoperatively.

Main Results:

• No statistically significant differences in pain scores were observed between the ketorolac and gabapentin groups at any assessment point.
• Both groups reported similar levels of current and average pain over the preceding 24 hours.
• There were no significant differences in eye symptoms or systemic adverse events between the two treatment groups.

Conclusions:

• Oral ketorolac and oral gabapentin demonstrate comparable efficacy in controlling postoperative pain and symptoms after both epi-on and epi-off CXL procedures.
• Both medications can be considered suitable options for pain management following CXL surgery.
• The choice between ketorolac and gabapentin may depend on other patient-specific factors or physician preference.