Hong Jin Pyo, Nam Sang Min, Im Chan Young, Yoon Sangchul, Kim Tae-Im, Kim Eung Kweon, Seo Kyoung Yul
From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
From the Saeyan Eye Center (Hong), the Ian Eye Center (Im), the Department of Ophthalmology (Yoon, T-i. Kim, E.K. Kim, Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea.
J Cataract Refract Surg. 2014 Oct;40(10):1689-96. doi: 10.1016/j.jcrs.2014.05.029. Epub 2014 Jun 24.
To investigate changes in the pain-suppressing potency of 2 preoperatively applied topical nonsteroidal antiinflammatory drugs (NSAIDs) after photorefractive keratectomy (PRK) using a time-serial pain-scoring system.
Saeyan Eye Center, Seoul, South Korea.
Comparative case series.
Ninety-four patients were randomly assigned to 2 groups: ketorolac group (ketorolac 0.5% in 1 eye and ofloxacin 0.3% in the other eye) and diclofenac group (diclofenac 0.1% in 1 eye and ofloxacin 0.3% in the other eye). One drop of each ophthalmic drug was applied 3 times to each eye 30 minutes before PRK. No other NSAID or steroid was prescribed until 4 days after PRK. The patients were asked to score the postoperative pain in each eye with a visual analog scale at 6, 18, 24, 36, 48, 72, and 96 hours.
The natural peak of pain was located between 24 and 36 hours. Initially, the degree of pain reduction was constant for both NSAIDs; it dropped after 24 hours and 36 hours in the ketorolac group and the diclofenac group, respectively. The postoperative time-serial pattern of the pain score changed in the diclofenac group but not in the ketorolac group compared with the pattern in the ofloxacin-treated eye. The visual outcome was not affected by either NSAID, and significant complications were not noticed for a mean of 7 months.
The duration and pattern of the action may vary according to types of NSAIDs. Preemptive topical diclofenac 0.1% was a safe and effective method for post-PRK pain control.
No author has a financial or proprietary interest in any material or method mentioned.
采用时间序列疼痛评分系统，研究两种术前应用的局部非甾体抗炎药（NSAIDs）在准分子激光角膜切削术（PRK）后疼痛抑制效力的变化。
韩国首尔赛扬眼科中心。
比较病例系列。
94例患者随机分为2组：酮咯酸组（一只眼用0.5%酮咯酸，另一只眼用0.3%氧氟沙星）和双氯芬酸组（一只眼用0.1%双氯芬酸，另一只眼用0.3%氧氟沙星）。在PRK前30分钟，每只眼各滴一滴上述眼科药物，每天3次。在PRK后4天内未开其他NSAID或类固醇药物。要求患者在术后6、18、24、36、48、72和96小时用视觉模拟量表对每只眼的术后疼痛进行评分。
疼痛的自然峰值出现在24至36小时之间。最初，两种NSAIDs的疼痛减轻程度是恒定的；酮咯酸组和双氯芬酸组分别在24小时和36小时后疼痛减轻程度下降。与氧氟沙星治疗眼相比，双氯芬酸组疼痛评分的术后时间序列模式发生了变化，而酮咯酸组未发生变化。两种NSAIDs均未影响视力结果，平均7个月未发现明显并发症。
作用的持续时间和模式可能因NSAIDs的类型而异。术前预防性使用0.1%双氯芬酸是一种安全有效的PRK后疼痛控制方法。
没有作者对文中提及的任何材料或方法拥有财务或专利权益。
