Effectiveness of ketorolac-soaked bandage contact lens for pain management after photorefractive keratectomy

Abstract

Objective

To evaluate the effect of ketorolac-soaked contact lenses (CLs) on postoperative pain after photorefractive keratectomy (PRK) and their potential side effects including conjunctival hyperaemia and delayed epithelial healing.

Methods

This is a prospective, randomised, double-blind, contralateral eye study. A total of 310 eyes of 155 patients who underwent PRK in both eyes were included in the study. After photoablation, a 0.4% ketorolac-soaked bandage CL was placed over the cornea in Group 1, while a drug-free soft bandage CL was placed over the cornea in Group 2. The postoperative pain was evaluated using a verbal numerical rating scale. The ocular redness was compared using the black pixels (veins, and areas of redness) and white pixels (remaining areas) of the images. The complications and time to corneal wound healing were also recorded.

Results

The mean pain score was significantly lower in Group 1 (2.7 ± 1.3) than in Group 2 (7.4 ± 1.4) on postoperative day 1 (p < 0.001). However, on the 3rd postoperative day, there was no significant difference between the groups in terms of pain scores (p = 0.42). Preoperative eye redness was 199.2 ± 16.0 pixels in Group 1 and 200.1 ± 17.6 pixels in Group 2 (p = 0.65). There was no statistically significant difference between the two groups in terms of eye redness at the postoperative 24th and 72nd hours (p = 0.43 and p = 0.39, respectively).

Conclusion

Soaking the bandage CL in a solution containing ketorolac 0.4% for 15 minutes could significantly lower pain scores on the first postoperative day after PRK, with no serious complications.

Keywords:

• Photorefractive keratectomy
• postoperative pain
• non-steroidal anti-inflammatory drugs
• ketorolac
• bandage contact lens

Acknowledgements

None.

Author contributions

Conceptualisation: F.U. Formal analysis: F.U. and E.K. Funding acquisition: F.U. Investigation: F.U. Methodology: F.U. Project administration: F.U. Resources: F.U. Software and visualisation: F.U. and E.K. Writing—review and editing: F.U. and E.K.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.