Analgesic Effect of Topical Nepafenac 0.1% on Pain Related to Intravitreal Injections: A Randomized Crossover Study

ABSTRACT

Purpose: To evaluate the analgesic effect of nepafenac 0.1%, a topical non-steroidal anti-inflammatory agent, in patients undergoing treatment with intravitreal injections (IVIs).

Material and methods: It is a single center, prospective, randomized, double-blinded, placebo-controlled, crossover interventional study. Fifty-two patients scheduled to undergo IVI of anti-vascular endothelial growth factors were included in the study. Patients were randomized in a 1:1 ratio to receive topical nepafenac 0.1% or placebo 1 h before subsequent IVIs. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the Visual Analogue Scale (VAS), the Main Component of the SF-MPQ (MC-SF-MPQ), and the Present Pain Intensity (PPI) scores immediately and 6-h post-injection.

Results: The VAS pain score was statistically significant lower immediately and 6-h post-IVI in patients treated with nepafenac (p = 0.001 and < 0.001, respectively). The MC-SF-MPQ scores were also statistically significant lower after nepafenac administration at both time points (p < 0.001). Finally, the PPI score was statistically significant lower when nepafenac was instilled before IVI (p = 0.015 immediately and p < 0.001 at 6-h post-injection).

Conclusions: A single drop of nepafenac 0.1% before IVI could effectively alleviate the IVI-related pain immediately and up to 6 h after the injection.

KEYWORDS:

• Intravitreal injections
• Nepafenac
• pain
• short form of the McGill Pain Questionnaire
• Visual Analogue Scale

Acknowledgments

The authors would like to thank Kalliroe Paschali (K.P.), Head Nurse of our Department, for her valuable contribution to this study.

Declaration of interests

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.