Comparison Between Diclofenac and Ketorolac Ophthalmic Drops for Pain Management After Photorefractive Keratectomy: A Randomized Clinical Study

Mohammadpour, Mehrdad; Heidari, Zahra; Molani, Ratishta

doi:10.1097/icl.0000000000000524

Cited by 9 publications

(5 citation statements)

References 27 publications

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“…34 These differences between study results may be attributed to different study designs and possibly different postoperative pain control methods between studies. 16,17,27,29 The superior results of alcohol-assisted epithelial removal relative to mechanical debridement might theoretically being supported by previous animal studies that reported less corneal haziness and an accelerated wound-healing. 37 Another hypothesis is that the alcohol-assisted technique provides a more uniform stromal bed on the cornea.…”

Section: Discussionmentioning

confidence: 85%

“…19 Another strategy to reduce pain experiment is the prescription of topical NSAIDs. 29,30 Despite the popularity of this medication among refractive surgeons, it is hypothesized that their use could interfere with the postrefractive healing of the cornea. 31 Besides, the intraoperative application of cold balanced saline solution over the cornea may relieve the postoperative pain.…”

Section: Fig 2 the Time Of Postoperative Pain Onset And Maximum Pain ...mentioning

confidence: 99%

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Comparison of Postoperative Symptoms of Alcohol-Assisted Versus Mechanical Epithelial Removal in Photorefractive Keratectomy: A Contralateral Double Blind Clinical Trial

Mohammadpour¹,

Rezaei²,

Heirani³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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To compare the short-term complaints of postoperative pain, and other ocular discomfort symptoms in patients who underwent photorefractive keratectomy (PRK) with alcohol-assisted epithelial removal in one eye versus mechanical debridement in the other eye. Method: A prospective, interventional, contralateral double blind clinical trial was performed on 164 eyes of 82 candidates of PRK surgery. The patients were divided into two groups. The first group was alcohol-assisted PRK group in which the epithelial removal was performed on their right eye. The second group was mechanical PRK group in which epithelial removal was performed on their left eye. A numerical rating scale was given to the patients to describe the severity of postoperative pain on the first day following PRK. Postoperative discomfort symptoms including the complaints of light sensitivity, tearing, blurring, and foreign body sensation was also provided by the survey form. Results: One day following PRK, the mean pain score of the alcoholassisted PRK group and the mechanical PRK group was 3.463.1 and 4.163.3, respectively (P¼0.019). The highest scores recorded for alcohol-assisted and mechanical treated groups were burning (5.22) and light sensitivity (5.46), respectively. Sixty-eight (82.9%) of all patients experienced postoperative pain, and in 52 (76.5%) of them, the time of pain onset was less than 2 hrs. Conclusion: We found less pain and discomfort using alcohol-assisted technique compared with mechanical epithelial removal that was provided by a detailed pain and ocular discomfort symptoms assessment one day following PRK surgery.

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Section: Discussionmentioning

confidence: 85%

Section: Fig 2 the Time Of Postoperative Pain Onset And Maximum Pain ...mentioning

confidence: 99%

Comparison of Postoperative Symptoms of Alcohol-Assisted Versus Mechanical Epithelial Removal in Photorefractive Keratectomy: A Contralateral Double Blind Clinical Trial

Mohammadpour¹,

Rezaei²,

Heirani³

et al. 2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

Self Cite

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“…16 Other studies report equal analgesic efficacy between topical NSAID agents in the management of postoperative pain. [17][18][19] For example, topical diclofenac and ketorolac had equal analgesic efficacy when evaluated at 24 and 72 hours after PRK. 19 Interestingly, when topical ketorolac was compared with oral naproxen sodium (220 mg), both administered every 12 hours for 72 hours, the topical NSAID was associated with a superior analgesic effect.…”

Section: Topical Nsaidsmentioning

confidence: 99%

“…[17][18][19] For example, topical diclofenac and ketorolac had equal analgesic efficacy when evaluated at 24 and 72 hours after PRK. 19 Interestingly, when topical ketorolac was compared with oral naproxen sodium (220 mg), both administered every 12 hours for 72 hours, the topical NSAID was associated with a superior analgesic effect. 20 Ketorolac (0.45%) is also effective at reducing post-PRK pain as assessed immediately postoperatively and on postoperative day 3 when applied as a soaked bandage contact lens.…”

Section: Topical Nsaidsmentioning

confidence: 99%

Topical analgesics for acute corneal pain: current options and emerging therapeutics

Lafreniere

Szczesniak

Courtney

et al. 2023

J Cataract Refract Surg

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Acute corneal pain is a common complaint that causes significant distress to patients and continues to challenge therapeutic avenues for pain management. Current topical treatment options have marked limitations in terms of both efficacy and safety, thus often prompting the adjunctive use of systemic analgesics, including opioids. In general, there have not been extensive advancements in pharmacologic options for the management of corneal pain over the past several decades. Despite this, multiple promising therapeutic avenues exist which hold the potential to transform the ocular pain landscape, including druggable targets within the endocannabinoid system. This review will summarize the current evidence base for topical nonsteroidal anti-inflammatory drugs, anticholinergic agents, and anesthetics before focusing on several potential avenues in the setting of acute corneal pain management, including autologous tear serum, topical opioids and endocannabinoid system modulators.

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“…Ketorolac is a non-selective NSAID that can affect the formation of cyclooxygenase (COX) and thus reduce the production of prostaglandins. In many studies, its analgesic effect is stronger than that of other NSAIDs, such as tramadol and diclofenac (10)(11)(12)(13). Therefore, ketorolac has been widely used in various types of postoperative analgesia for colorectal surgery (14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Ketorolac Administration After Colorectal Surgery Increases Anastomotic Leak Rate: A Meta-Analysis and Systematic Review

et al. 2022

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ObjectiveThis meta-analysis aimed to evaluate whether ketorolac administration is associated with an increased anastomotic leak rate after colorectal surgery.MethodsThe literature was searched using the Web of Science, Embase, and PubMed databases, and the search ended on May 31, 2020. The Newcastle–Ottawa Scale was used to assess methodological quality. Statistical heterogeneity was assessed using the Chi-square Q test and I2 statistics. Subgroup analysis was performed, and Egger's test was used to assess publication bias.ResultsThis meta-analysis included seven studies with 400,822 patients. Our results demonstrated that ketorolac administration after surgery increases the risk of anastomotic leak [OR = 1.41, 95% CI: 0.81–2.49, Z = 1.21, P = 0.23]. Low heterogeneity was observed across these studies (I2 = 0%, P = 0.51). The results of subgroup analysis showed that the use of ketorolac in case–control and retrospective cohort studies significantly increased the risk of anastomotic leak (P < 0.05). Furthermore, the subgroup analysis revealed that ketorolac use increased anastomotic leak rate in patients in the United States and Canada, and ketorolac plus morphine use did not increase anastomotic leak rate in Taiwanese patients (P < 0.05). No significant publication bias was observed (P = 0.126). Moreover, the analysis of risk factors related to anastomotic leak rate indicated that the total use of ketorolac did not increase the risk of anastomotic leak similar to the control group (P > 0.05).ConclusionThe meta-analysis indicates that the use of ketorolac increases the risk of anastomotic leak after colorectal surgery.Systematic Review RegistrationPROSPERO, identifier CRD42020195724.

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Comparison Between Diclofenac and Ketorolac Ophthalmic Drops for Pain Management After Photorefractive Keratectomy: A Randomized Clinical Study

Abstract: Both diclofenac and ketorolac are effective in reducing pain and ocular discomfort after PRK, and ketorolac may have greater control on tearing and photophobia during the first 24 postoperative hours.

Cited by 9 publications

References 27 publications

Comparison of Postoperative Symptoms of Alcohol-Assisted Versus Mechanical Epithelial Removal in Photorefractive Keratectomy: A Contralateral Double Blind Clinical Trial

Comparison of Postoperative Symptoms of Alcohol-Assisted Versus Mechanical Epithelial Removal in Photorefractive Keratectomy: A Contralateral Double Blind Clinical Trial

Topical analgesics for acute corneal pain: current options and emerging therapeutics

Ketorolac Administration After Colorectal Surgery Increases Anastomotic Leak Rate: A Meta-Analysis and Systematic Review

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