Purpose: To compare the efficacy and safety of topical diclofenac and tetracaine in reducing ocular pain after photorefractive keratectomy.
Setting: Ophthalmology Department, Minjoz Hospital, Besançon, France.
Methods: Seventy-four patients were randomized to receive either tetracaine 1% or diclofenac 0.1% after undergoing PRK. Tetracaine was instilled at 30 minute intervals for 24 hours. Diclofenac was instilled four times a day for 3 days. All patients were allowed to use oral Diantalvic (paracetamol-noramidopyrine) as a rescue analgesic if the study medications failed to control the ocular pain. Visual analog pain charts were used to record pain levels every hour for 30 hours after surgery. A subjective questionnaire was to be completed by the patient to evaluate discomfort every day for 3 days. Computer analysis of photography performed at D0, D1, D3, was used to evaluate the rate of epithelial closure.
Results: Women had significantly more pain. Patients in the diclofenac group had significantly less pain. No statistically significant difference was seen in the rate of epithelial closure.
Conclusion: Diclofenac is more effective than tetracaine to reduce ocular pain and functional symptoms.