Topical Diclofenac Reduces Pain Following Photorefractive Keratectomy

Severe postoperative pain has been a significant complication of excimer laser photorefractive keratectomy (PRK). We report herein the dramatic effect of topical diclofenac sodium (Voltaren Ophthalmic) for relieving patient discomfort following PRK.

We performed a retrospective analysis of 20 consecutive patients who had undergone bilateral PRK for myopia as part of a phase III US Food and Drug Administration study (the second eye was operated on 6 months after the first). Initially treated eyes were generally the more myopic of the two. Following PRK using topical anesthesia, one drop each of tobramycin, 0.25% scopolamine, and 0.1% fluorometholone were administered and a disposable contact lens was placed on the eye. The patients were instructed to use the tobramycin four times a day and the 0.1% fluorometholone every 2 hours while awake. The regimen was identical in the second eye with the exception ofthe addition of 0.1% diclofenac four times a day.