Management of pain with diclofenac after femtosecond-assisted laser in situ keratomileusis

Abstract

To evaluate the safety and efficacy of topical diclofenac sodium 0.1% after femtosecond laser-assisted laser in situ keratomileusis (LASIK). W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA. Clinical trial. Pain was assessed in patients treated with topical diclofenac sodium 0.1% or artificial tears immediately after LASIK using a numeric pain scale and a combined picture-numeric pain scale 0, 2, 4, 12, and 24 hours postoperatively. Visual outcomes and complications were noted up to 24 hours. The study enrolled 100 eyes of 50 patients. Patients treated with diclofenac 0.1% reported less pain than the control group on both pain scales 2, 4, 12, and 24 hours after surgery, with the maximum benefit at 4 hours (P=.02). Fewer patients in the diclofenac group (76.0%) than in the control group (91.3%) used oral pain and/or anxiolytic medications during the first 24 hours after surgery (P=.25). Ninety-eight eyes had an uncorrected distance visual acuity of 20/40 or better. Mild peripheral diffuse lamellar keratitis accounted for the majority of perioperative complications (n = 15). Pain after femtosecond laser-assisted LASIK was mild and was reduced with a single dose of topical diclofenac sodium 0.1% given immediately after surgery.