Post-Intravitreal injection pain reduction using topical NSAIDS: A comparative study

Area of Science:

• Ophthalmology
• Pharmacology
• Clinical Research

Background:

• Intravitreal injections (IVIs) are common treatments for various retinal diseases.
• Post-injection pain is a frequent patient complaint, potentially impacting treatment adherence.
• Topical non-steroidal anti-inflammatory drugs (NSAIDs) are often used for pain management.

Purpose of the Study:

• To compare the efficacy of topical NSAID eye drops with and without preservatives in managing pain after IVIs.
• To evaluate the impact of preservative-free diclofenac versus nepafenac and a control group on post-injection pain.

Main Methods:

• A prospective, randomized, placebo-controlled, single-blinded study involving 252 patients (308 eyes).
• Participants received either preservative-free diclofenac 0.1%, nepafenac 0.1%, or artificial tears immediately post-IVI.
• Pain scores were assessed immediately, 6 hours, and 24 hours after the intravitreal injection.

Main Results:

• Preservative-free diclofenac showed significantly lower mean pain scores at 6 hours post-IVI compared to nepafenac and the control group (p=0.03).
• No statistically significant differences in pain scores were observed between any groups at 24 hours post-injection.
• While patients reported less pain compared to previous IVIs, these findings were not statistically significant.

Conclusions:

• Topical preservative-free NSAIDs, specifically diclofenac, appear superior to preservative-containing NSAIDs for immediate post-IVI pain relief.
• Preservative-free NSAIDs may be a valuable addition to the treatment protocol for patients undergoing IVIs.
• Further research could explore long-term pain management and patient-reported outcomes.