Assouline M, Renard G, Arne J L, David T, Lasmolles C, Malecaze F, Pouliquen Y J
Department of Ophthalmology, Hôtel-Dieu de Paris, INSERM U86, University of Paris VI, Medical School, France.
Ophthalmic Surg Lasers. 1998 May;29(5):365-74.
To compare the safety and efficacy of topical nonsteroidal antiinflammatory drugs (NSAIDs) for the control of pain after excimer laser photorefractive keratectomy (PRK).
One hundred twenty informed patients were enrolled in a double-masked, randomized, comparative study and assigned to either 0.1% indomethacin, 0.1% diclofenac, or placebo treatment. Subjective postoperative pain, symptoms, re-epithelialization rate, and systemic medications were monitored for 2 days following photoablation.
Compared with the placebo, 0.1% indomethacin solution significantly reduced pain on the day of surgery (D0) (P < .05), whereas 0.1% diclofenac did not reach a significant level (P = .46). At D0, analgesic intake by the oral route was significantly greater in the placebo group (P < .05). Severe photophobia was significantly less frequent in the group treated with 0.1% indomethacin (P < .05). Corneal wound healing was significantly delayed in the patients treated with 0.1% diclofenac at D2 as compared with other groups (P = .04).
Topical 0.1% indomethacin solution helps control the pain induced by excimer laser photoablation of the cornea without any detrimental effect to the corneal epithelial wound healing.
比较局部使用非甾体抗炎药（NSAIDs）控制准分子激光屈光性角膜切削术（PRK）后疼痛的安全性和有效性。
120名知情患者参与了一项双盲、随机、对照研究，被分配接受0.1%吲哚美辛、0.1%双氯芬酸或安慰剂治疗。光凝术后2天监测患者术后主观疼痛、症状、角膜上皮再形成率及全身用药情况。
与安慰剂相比，0.1%吲哚美辛溶液在手术当天（D0）显著减轻疼痛（P <.05），而0.1%双氯芬酸未达到显著水平（P = 0.46）。在D0时，安慰剂组口服镇痛药的摄入量显著更高（P <.05）。0.1%吲哚美辛治疗组严重畏光的发生率显著更低（P <.05）。与其他组相比，0.1%双氯芬酸治疗的患者在D2时角膜伤口愈合显著延迟（P = 0.04）。
局部使用0.1%吲哚美辛溶液有助于控制准分子激光角膜光凝术引起的疼痛，且对角膜上皮伤口愈合无任何不利影响。
