Which is a better preventive pain regimen after photorefractive keratectomy: oral or topical NSAIDs?

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are better at reducing postoperative pain in patients after photorefractive keratectomy (PRK) than oral NSAIDs.

In this prospective, randomized, longitudinal survey 157 patients were randomized to receive topical ketorolac 0.4% every 12 hours or oral naproxen sodium 220 mg every 12 hours for 72 hours following PRK before completing a survey on postoperative PRK pain. In patients receiving oral NSAIDs, the peak pain scores were significantly higher than those receiving topical NSAIDs. Pain scores 24 to 48 hours after PRK were significant higher in the oral NSAID group than the topical group. Pain scores were the highest 24–72 hours after surgery in all patients.

Reference

Survey of postoperative pain in photorefractive keratectomy using topical versus oral nonsteroidal anti-inflammatory drugs. Clin Ophthalmol. 2020; 2020(14):1459-1466. DOI https://doi.org/10.2147/OPTH.S255441