Comparison of postoperative pain in photorefractive keratectomy using topical versus oral nonsteroidal anti–inflammatory drugs

Abstract

Objective: Most of the ophthalmic surgery is done under topical anesthesia or nerve blocks. Local anesthetic agents are usually used for both analgesic techniques. We hypothesized that nonsteroidal anti–inflammatory drugs (NSAIDs) could be used preoperatively for postoperative pain, either topically or by oral route. Present study aimed to compare mean reduction in pain scores with oral versus topical NSAIDs following photorefractive keratectomy. \nMethodology: This prospective study was conducted at Department of Ophthalmology, Eye Donors Organization (EDO) Hospital, Wah Cantt, for 6 months (March 2019–August 2019). A sample size of 40 patients was calculated using World Health Organization calculator. We selected patients through convenient (non–probability) sampling. We took IRB approval, and written consent form the patients. All patients underwent photorefractive keratectomy. Patients were randomly divided (lottery method) into two groups; Group A was treated with topical NSAIDs while group B was treated with oral NSAIDs. Patients were followed for 3 days. We measured pain scores using visual analogue pain scale (VAS). Data analysis was done using SPSS version 24. T–test and fissure exact test were applied. A p ≤ 0.05 was considered significant. \nResults: A total of 40 patients were included in study. Mean age of patients was 28.1 ± 2.9 y. There were 21(52.5%) males and 19(46.3%) females. Topical NSAIDs showed significant reduction in pain scores as compared to oral NSAIDs at day 1 (5.25 ± 0.6 vs. 7.20 ± 0.69, p = 0.000), day 2 (4.15 ± 0.5 vs. 6.65 ± 0.48, p = 0.000) day 3 (2.25 ± 0.63 vs. 6.15 ± 0.74, p = 0.000). \nConclusion: Topical nonsteroidal anti–inflammatory drugs are safe and effective for reducing postoperative pain management following photorefractive keratectomy as compared to oral nonsteroidal anti– inflammatory drugs. \nKey words: Nonsteroidal anti–inflammatory drugs; Pain; Photorefractive keratectomy \nCitation: Javaid S, Shafi M, Lodhi Y. Comparison of postoperative pain in photorefractive keratectomy using topical versus oral nonsteroidal anti–inflammatory drugs. Anaesth. pain intensive care 2021;25(3):324–328. DOI: doi.org/10.35975/apic.v25i3.1527 \nReceived: January 29, 2021, Reviewed: February 27, March 13, 2021, Accepted: March 31, 2021