Yee R W
University of Texas at Houston, 77030, USA.
Am J Ophthalmol. 1998 Apr;125(4):472-80. doi: 10.1016/s0002-9394(99)80187-1.
To compare the analgesic efficacy and safety of nonpreserved ketorolac tromethamine 0.5% with those of its vehicle in the treatment of postsurgical ocular pain following radial keratotomy.
This study employed a multicenter, double-masked, randomized, parallel-group design. Radial keratotomy patients were treated with either nonpreserved ketorolac tromethamine 0.5% or its vehicle four times daily for up to 3 days following surgery. Patients were provided with an escape medication (acetaminophen) for use only as needed for intolerable pain.
Patients treated with ketorolac reported significantly greater pain relief (P < or =.023), less pain intensity (P < or =.047), less use of escape medication (P < or =.001), fewer symptoms of ocular discomfort (P=.024), and fewer sleep disturbances (P < or =.013) than did patients treated with vehicle. No treatment-related adverse events were reported in the ketorolac group, and only one treatment-related adverse event was reported in the vehicle group. Most other safety findings were equivalent in the two treatment groups except that there were significantly less eyelid erythema (P=.026) and eyelid edema (P < or =.001) in the ketorolac group.
Nonpreserved ketorolac tromethamine 0.5% ophthalmic solution was significantly more effective than, and as safe as, vehicle in the treatment of postoperative pain associated with radial keratotomy. Therefore, topical ketorolac may be a valuable treatment option for the maintenance of patient comfort following refractive surgery.
比较0.5%的无防腐剂酮咯酸氨丁三醇与其赋形剂治疗放射状角膜切开术后眼部手术疼痛的镇痛效果和安全性。
本研究采用多中心、双盲、随机、平行组设计。放射状角膜切开术患者在术后最多3天内,每天使用0.5%的无防腐剂酮咯酸氨丁三醇或其赋形剂4次。仅在患者出现难以忍受的疼痛时,才提供备用药物(对乙酰氨基酚)。
与使用赋形剂的患者相比,使用酮咯酸治疗的患者报告疼痛缓解更显著(P≤0.023),疼痛强度更低(P≤0.047),备用药物使用更少(P≤0.001),眼部不适症状更少(P = 0.024),睡眠障碍更少(P≤0.013)。酮咯酸组未报告与治疗相关的不良事件,赋形剂组仅报告了1例与治疗相关的不良事件。除酮咯酸组的眼睑红斑(P = 0.026)和眼睑水肿(P≤0.001)明显较少外,两个治疗组的大多数其他安全性结果相当。
0.5%的无防腐剂酮咯酸氨丁三醇滴眼液在治疗放射状角膜切开术相关的术后疼痛方面比赋形剂显著更有效且同样安全。因此,局部使用酮咯酸可能是屈光手术后维持患者舒适度的一种有价值的治疗选择。