Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial
Background A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy. Design Prospective randomized,...
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| Veröffentlicht in: | Clinical & experimental ophthalmology 2014-12, Vol.42 (9), p.810-814 |
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| creator | Eslampoor, Alireza Ehsaei, Asieh Abrishami, Mojtaba |
| description | Background
A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy.
Design
Prospective randomized, double‐masked clinical trial applied in the Khatam‐al‐Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Participants
Sixty‐eight individuals (age range, 18–35 years) having bilateral photorefractive keratectomy for myopic correction with or without astigmatism.
Methods
All patients received 100 mg of extended‐release oral diclofenac two times (12‐h interval) before photorefractive keratectomy surgery. Postoperatively, patients were randomized into the case and control groups. Case group was administered the diclofenac 0.1% drop, one drop 2 h preoperatively and four times daily postoperatively for 3 days, whereas the control group was given artificial tears instead.
Main Outcome Measures
Pain level, photophobia and functional activity were evaluated by the patient after operation.
Results
Two days after surgery, no statistically significant difference in pain level was noted between both groups. In addition, photophobia and functional activity was not different between the case and control groups. Eyelid oedema and conjunctival injection levels were significantly higher in the control group (P |
| doi_str_mv | 10.1111/ceo.12343 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1639493392</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3528674181</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4163-d68bacb8dd4c5178ba9b0943e13b20cc599e0baf45b3a8734efcb2f99f05d1ff3</originalsourceid><addsrcrecordid>eNp1kU1vFSEUhklT0y9d9A80JN3YxGlhYD5wZybX1ljbjcakG8LAIaVlhhHmqtdfL7f3tgsT2cDJec57yPsidEzJOc3nQkM4pyXjbAcdUM7LQpCG7m7fNSd8Hx2m9EAIqUpW76H9kteiravyAI0La0HPOFg8h8lp5bFx2gcLo9I4jHgKKTcgqtn9BDzdhzlEsFHpp_px3cjzYVjhSbnxPVY4qtGEwf0B8w7rMM4xeA8Gz9Ep_xq9ssoneLO9j9C3j4uv3VVxfXv5qftwXWhOa1aYuu2V7ltjuK5okwvRE8EZUNaXROtKCCC9srzqmWobxsHqvrRCWFIZai07Qm83ulMMP5aQZjm4pMF7NUJYJpmXCC4YE2VGT_9BH8Iyjvl3a6rOLjHRZupsQ-kYUsoOyCm6QcWVpESuQ5A5BPkUQmZPtorLfgDzQj67noGLDfDLeVj9X0l2i9tnyWIz4dIMv18mVHyUdcOaSn6_uZSfr-5uui8dk4T9BfNZobM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1636652398</pqid></control><display><type>article</type><title>Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial</title><source>Access via Wiley Online Library</source><source>MEDLINE</source><creator>Eslampoor, Alireza ; Ehsaei, Asieh ; Abrishami, Mojtaba</creator><creatorcontrib>Eslampoor, Alireza ; Ehsaei, Asieh ; Abrishami, Mojtaba</creatorcontrib><description>Background
A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy.
Design
Prospective randomized, double‐masked clinical trial applied in the Khatam‐al‐Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Participants
Sixty‐eight individuals (age range, 18–35 years) having bilateral photorefractive keratectomy for myopic correction with or without astigmatism.
Methods
All patients received 100 mg of extended‐release oral diclofenac two times (12‐h interval) before photorefractive keratectomy surgery. Postoperatively, patients were randomized into the case and control groups. Case group was administered the diclofenac 0.1% drop, one drop 2 h preoperatively and four times daily postoperatively for 3 days, whereas the control group was given artificial tears instead.
Main Outcome Measures
Pain level, photophobia and functional activity were evaluated by the patient after operation.
Results
Two days after surgery, no statistically significant difference in pain level was noted between both groups. In addition, photophobia and functional activity was not different between the case and control groups. Eyelid oedema and conjunctival injection levels were significantly higher in the control group (P < 0.001).
Conclusions
Administration of topical diclofenac to a standardized postoperative pain regime did not alleviate post‐photorefractive keratectomy pain, although it is effective in local signs like eyelid oedema and conjunctival injection. It can be concluded that oral diclofenac is sufficient in the management of post‐photorefractive keratectomy pain and addition of the topical diclofenac is unnecessary.</description><identifier>ISSN: 1442-6404</identifier><identifier>EISSN: 1442-9071</identifier><identifier>DOI: 10.1111/ceo.12343</identifier><identifier>PMID: 24698652</identifier><language>eng</language><publisher>Australia: Blackwell Publishing Ltd</publisher><subject>Administration, Topical ; Adolescent ; Adult ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use ; cornea ; diclofenac ; Diclofenac - adverse effects ; Diclofenac - therapeutic use ; Double-Blind Method ; Eye Pain - drug therapy ; Eye Pain - etiology ; Female ; Humans ; Male ; Medical treatment ; Myopia - surgery ; Ophthalmic Solutions ; Pain ; Pain Management ; Pain, Postoperative - drug therapy ; Pain, Postoperative - etiology ; photorefractive keratectomy ; Photorefractive Keratectomy - adverse effects ; Prospective Studies ; Refraction, Ocular - physiology ; Visual Acuity - physiology ; Young Adult</subject><ispartof>Clinical & experimental ophthalmology, 2014-12, Vol.42 (9), p.810-814</ispartof><rights>2014 Royal Australian and New Zealand College of Ophthalmologists</rights><rights>2014 Royal Australian and New Zealand College of Ophthalmologists.</rights><rights>Copyright © 2014 Royal Australian and New Zealand College of Ophthalmologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4163-d68bacb8dd4c5178ba9b0943e13b20cc599e0baf45b3a8734efcb2f99f05d1ff3</citedby><cites>FETCH-LOGICAL-c4163-d68bacb8dd4c5178ba9b0943e13b20cc599e0baf45b3a8734efcb2f99f05d1ff3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fceo.12343$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fceo.12343$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24698652$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Eslampoor, Alireza</creatorcontrib><creatorcontrib>Ehsaei, Asieh</creatorcontrib><creatorcontrib>Abrishami, Mojtaba</creatorcontrib><title>Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial</title><title>Clinical & experimental ophthalmology</title><addtitle>Clin Experiment Ophthalmol</addtitle><description>Background
A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy.
Design
Prospective randomized, double‐masked clinical trial applied in the Khatam‐al‐Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Participants
Sixty‐eight individuals (age range, 18–35 years) having bilateral photorefractive keratectomy for myopic correction with or without astigmatism.
Methods
All patients received 100 mg of extended‐release oral diclofenac two times (12‐h interval) before photorefractive keratectomy surgery. Postoperatively, patients were randomized into the case and control groups. Case group was administered the diclofenac 0.1% drop, one drop 2 h preoperatively and four times daily postoperatively for 3 days, whereas the control group was given artificial tears instead.
Main Outcome Measures
Pain level, photophobia and functional activity were evaluated by the patient after operation.
Results
Two days after surgery, no statistically significant difference in pain level was noted between both groups. In addition, photophobia and functional activity was not different between the case and control groups. Eyelid oedema and conjunctival injection levels were significantly higher in the control group (P < 0.001).
Conclusions
Administration of topical diclofenac to a standardized postoperative pain regime did not alleviate post‐photorefractive keratectomy pain, although it is effective in local signs like eyelid oedema and conjunctival injection. It can be concluded that oral diclofenac is sufficient in the management of post‐photorefractive keratectomy pain and addition of the topical diclofenac is unnecessary.</description><subject>Administration, Topical</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</subject><subject>cornea</subject><subject>diclofenac</subject><subject>Diclofenac - adverse effects</subject><subject>Diclofenac - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Eye Pain - drug therapy</subject><subject>Eye Pain - etiology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Myopia - surgery</subject><subject>Ophthalmic Solutions</subject><subject>Pain</subject><subject>Pain Management</subject><subject>Pain, Postoperative - drug therapy</subject><subject>Pain, Postoperative - etiology</subject><subject>photorefractive keratectomy</subject><subject>Photorefractive Keratectomy - adverse effects</subject><subject>Prospective Studies</subject><subject>Refraction, Ocular - physiology</subject><subject>Visual Acuity - physiology</subject><subject>Young Adult</subject><issn>1442-6404</issn><issn>1442-9071</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1vFSEUhklT0y9d9A80JN3YxGlhYD5wZybX1ljbjcakG8LAIaVlhhHmqtdfL7f3tgsT2cDJec57yPsidEzJOc3nQkM4pyXjbAcdUM7LQpCG7m7fNSd8Hx2m9EAIqUpW76H9kteiravyAI0La0HPOFg8h8lp5bFx2gcLo9I4jHgKKTcgqtn9BDzdhzlEsFHpp_px3cjzYVjhSbnxPVY4qtGEwf0B8w7rMM4xeA8Gz9Ep_xq9ssoneLO9j9C3j4uv3VVxfXv5qftwXWhOa1aYuu2V7ltjuK5okwvRE8EZUNaXROtKCCC9srzqmWobxsHqvrRCWFIZai07Qm83ulMMP5aQZjm4pMF7NUJYJpmXCC4YE2VGT_9BH8Iyjvl3a6rOLjHRZupsQ-kYUsoOyCm6QcWVpESuQ5A5BPkUQmZPtorLfgDzQj67noGLDfDLeVj9X0l2i9tnyWIz4dIMv18mVHyUdcOaSn6_uZSfr-5uui8dk4T9BfNZobM</recordid><startdate>201412</startdate><enddate>201412</enddate><creator>Eslampoor, Alireza</creator><creator>Ehsaei, Asieh</creator><creator>Abrishami, Mojtaba</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201412</creationdate><title>Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial</title><author>Eslampoor, Alireza ; Ehsaei, Asieh ; Abrishami, Mojtaba</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4163-d68bacb8dd4c5178ba9b0943e13b20cc599e0baf45b3a8734efcb2f99f05d1ff3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Administration, Topical</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - therapeutic use</topic><topic>cornea</topic><topic>diclofenac</topic><topic>Diclofenac - adverse effects</topic><topic>Diclofenac - therapeutic use</topic><topic>Double-Blind Method</topic><topic>Eye Pain - drug therapy</topic><topic>Eye Pain - etiology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Myopia - surgery</topic><topic>Ophthalmic Solutions</topic><topic>Pain</topic><topic>Pain Management</topic><topic>Pain, Postoperative - drug therapy</topic><topic>Pain, Postoperative - etiology</topic><topic>photorefractive keratectomy</topic><topic>Photorefractive Keratectomy - adverse effects</topic><topic>Prospective Studies</topic><topic>Refraction, Ocular - physiology</topic><topic>Visual Acuity - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Eslampoor, Alireza</creatorcontrib><creatorcontrib>Ehsaei, Asieh</creatorcontrib><creatorcontrib>Abrishami, Mojtaba</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical & experimental ophthalmology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Eslampoor, Alireza</au><au>Ehsaei, Asieh</au><au>Abrishami, Mojtaba</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial</atitle><jtitle>Clinical & experimental ophthalmology</jtitle><addtitle>Clin Experiment Ophthalmol</addtitle><date>2014-12</date><risdate>2014</risdate><volume>42</volume><issue>9</issue><spage>810</spage><epage>814</epage><pages>810-814</pages><issn>1442-6404</issn><eissn>1442-9071</eissn><abstract>Background
A major disadvantage of photorefractive keratectomy is postoperative pain and discomfort. This study aims to evaluate whether topical diclofenac 0.1% therapy adds any extra benefit to systemic diclofenac in controlling pain after photorefractive keratectomy.
Design
Prospective randomized, double‐masked clinical trial applied in the Khatam‐al‐Anbia Eye Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Participants
Sixty‐eight individuals (age range, 18–35 years) having bilateral photorefractive keratectomy for myopic correction with or without astigmatism.
Methods
All patients received 100 mg of extended‐release oral diclofenac two times (12‐h interval) before photorefractive keratectomy surgery. Postoperatively, patients were randomized into the case and control groups. Case group was administered the diclofenac 0.1% drop, one drop 2 h preoperatively and four times daily postoperatively for 3 days, whereas the control group was given artificial tears instead.
Main Outcome Measures
Pain level, photophobia and functional activity were evaluated by the patient after operation.
Results
Two days after surgery, no statistically significant difference in pain level was noted between both groups. In addition, photophobia and functional activity was not different between the case and control groups. Eyelid oedema and conjunctival injection levels were significantly higher in the control group (P < 0.001).
Conclusions
Administration of topical diclofenac to a standardized postoperative pain regime did not alleviate post‐photorefractive keratectomy pain, although it is effective in local signs like eyelid oedema and conjunctival injection. It can be concluded that oral diclofenac is sufficient in the management of post‐photorefractive keratectomy pain and addition of the topical diclofenac is unnecessary.</abstract><cop>Australia</cop><pub>Blackwell Publishing Ltd</pub><pmid>24698652</pmid><doi>10.1111/ceo.12343</doi><tpages>5</tpages></addata></record> |
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| ispartof | Clinical & experimental ophthalmology, 2014-12, Vol.42 (9), p.810-814 |
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| subjects | Administration, Topical Adolescent Adult Anti-Inflammatory Agents, Non-Steroidal - adverse effects Anti-Inflammatory Agents, Non-Steroidal - therapeutic use cornea diclofenac Diclofenac - adverse effects Diclofenac - therapeutic use Double-Blind Method Eye Pain - drug therapy Eye Pain - etiology Female Humans Male Medical treatment Myopia - surgery Ophthalmic Solutions Pain Pain Management Pain, Postoperative - drug therapy Pain, Postoperative - etiology photorefractive keratectomy Photorefractive Keratectomy - adverse effects Prospective Studies Refraction, Ocular - physiology Visual Acuity - physiology Young Adult |
| title | Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial |
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