Donnenfeld Eric D, Holland Edward J, Durrie Daniel S, Raizman Michael B
Ophthalmic Consultants of Long Island, Rockville Centre, New York 11570, USA.
Adv Ther. 2007 Jul-Aug;24(4):852-62. doi: 10.1007/BF02849978.
Two NSAIDs--nepafenac 0.1% and ketorolac tromethamine 0.4%-were compared in terms of their effects on corneal reepithelialization and pain after photorefractive keratectomy (PRK) in a randomized, double-masked, contralateral eye, multicenter study. A total of 40 healthy adult patients who were undergoing sequential bilateral PRK received nepafenac 0.1% and ketorolac 0.4% in contralateral eyes, 1 drop 3 times daily for 3 d after bandage contact lens insertion. Patients were assessed on postoperative days 1, 3, 4, 5, and 7. At each visit, patients provided a general rating of pain. Each patient also assessed the sensation of each eyedrop following instillation (after-drop pain, irritation, burning/stinging, and overall comfort). Starting on day 3, epithelial defect size was assessed. Mean epithelial defect size was similar between treatments at each postoperative visit (P>.05). The average time-to-healing was 4.18 d for nepafenac 0.1% and 4.00 d for ketorolac 0.4% (P=.3134). No statistical difference was observed between nepafenac 0.1% and ketorolac 0.4% in mean postoperative pain scores (P>.05). On day 3, the nepafenac 0.1% group had significantly lower mean sensation scores than did the ketorolac 0.4% group for after-drop pain (P=.0090), irritation (P=.0007), and burning/ stinging (P=.0003). Mean overall comfort score was also significantly better for nepafenac 0.1% on day 3 (7.43 vs 6.41; P<.0001). Nepafenac 0.1% and ketorolac 0.4% provide postoperative pain relief after PRK surgery without associated adverse effects on corneal epithelial healing. Nepafenac 0.1% treatment may offer greater comfort upon instillation in patients who have undergone PRK.
在一项随机、双盲、对侧眼、多中心研究中，比较了两种非甾体抗炎药——0.1%的萘非那酮和0.4%的酮咯酸氨丁三醇对屈光性角膜切削术（PRK）后角膜再上皮化和疼痛的影响。共有40例接受双侧序贯PRK的健康成年患者，其对侧眼分别接受0.1%的萘非那酮和0.4%的酮咯酸氨丁三醇治疗，在插入绷带式隐形眼镜后每天3次，每次1滴，持续3天。在术后第1、3、4、5和7天对患者进行评估。每次就诊时，患者对疼痛进行总体评分。每位患者还在滴入每种眼药水后评估其感觉（滴药后疼痛、刺激、灼烧/刺痛和总体舒适度）。从第3天开始，评估上皮缺损大小。在每次术后就诊时，各治疗组之间的平均上皮缺损大小相似（P>0.05）。0.1%的萘非那酮组平均愈合时间为4.18天，0.4%的酮咯酸氨丁三醇组为4.00天（P = 0.3134）。0.1%的萘非那酮和0.4%的酮咯酸氨丁三醇在术后平均疼痛评分上无统计学差异（P>0.05）。在第3天，0.1%的萘非那酮组在滴药后疼痛（P = 0.0090）、刺激（P = 0.0007）和灼烧/刺痛（P = 0.0003）方面的平均感觉评分显著低于0.4%的酮咯酸氨丁三醇组。0.1%的萘非那酮组在第3天的平均总体舒适度评分也显著更好（7.43对6.41；P<0.0001）。0.1%的萘非那酮和0.4%的酮咯酸氨丁三醇在PRK手术后可缓解术后疼痛，且对角膜上皮愈合无相关不良影响。对于接受PRK的患者，0.1%的萘非那酮治疗在滴入时可能会提供更大的舒适度。
