Efficacy and safety of pain relief medications after photorefractive keratectomy: review of prospective randomized trials.

Abstract

UNLABELLED:

The objective of this review was to provide a comprehensive overview and comparison of results from all prospective randomized trials published to date of medications used to treat pain after photorefrative keratectomy (PRK). A PubMed database search revealed 23 prospective and randomized studies. They included the following classes of medications: nonsteroidal antiimflammatory drugs (NSAIDs), anesthetics, opiates, acetaminophen, gabapentin, and pregabalin. The studies found that although the efficacy of drugs tended to be similar, tetracaine 1% and nepafenac 0.1% tended to have the most analgesic effect. Delayed corneal reepithelialization was a common side effect of both topical anesthetics and topical NSAIDs. Tetracaine 1% resulted in the most significant delay in reepithelialization when tested against placebo control compared with other topical medications tested against placebo. Concomitant use of topical NSAIDs and topical anesthetics, especially tetracaine, may have to be avoided to minimize the risk for delayed corneal healing.

FINANCIAL DISCLOSURE:

Neither author has a financial or proprietary interest in any material or method mentioned.

• Authors: Ella G Faktorovich, Karishma Melwani
• Journal: Journal of cataract and refractive surgery (J Cataract Refract Surg) Vol. 40 Issue 10 Pg. 1716-30 (Oct 2014) ISSN: 1873-4502 [Electronic] United States
• PMID: 25263042 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Chemical References

• Amines
• Analgesics
• Analgesics, Opioid
• Anesthetics, Local
• Anti-Inflammatory Agents, Non-Steroidal
• Cyclohexanecarboxylic Acids
• Pregabalin
• gamma-Aminobutyric Acid
• Gabapentin

Topics

• Amines (adverse effects, therapeutic use)
• Analgesics (adverse effects, therapeutic use)
• Analgesics, Opioid (adverse effects, therapeutic use)
• Anesthetics, Local (adverse effects, therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (adverse effects, therapeutic use)
• Cyclohexanecarboxylic Acids (adverse effects, therapeutic use)
• Eye Pain (drug therapy)
• Gabapentin
• Humans
• Pain, Postoperative (drug therapy)
• Photorefractive Keratectomy
• Pregabalin
• Prospective Studies
• Randomized Controlled Trials as Topic
• Treatment Outcome
• gamma-Aminobutyric Acid (adverse effects, analogs & derivatives, therapeutic use)