Comparison Between Diclofenac and Ketorolac Ophthalmic Drops for Pain Management After Photorefractive Keratectomy: A Randomized Clinical Study

Objectives: To assess and compare the efficacy of two nonsteroidal anti-inflammatory drugs (NSAIDs), namely diclofenac and ketorolac, for pain control after photorefractive keratectomy (PRK). Methods: In this double-masked clinical study, 60 patients treated bilaterally with PRK were randomly allocated into two groups. Postoperatively, one group of patients received diclofenac 0.1% drops and the other group was prescribed ketorolac 0.5% ophthalmic drops in both eyes every 6 hr on the first day and then, no NSAID was applied until the third day. No oral analgesic drug was used after surgery. Patients completed the Visual Analog Scale questionnaire to determine the degree of pain and ocular discomfort (tearing, foreign body sensation, blurred vision, and photophobia) on the first and the third day after surgery. Results: Pain relief was achieved with both medications after surgery, and there was no significant intergroup difference in the level of pain reduction at 24 and 72 hr postoperatively (P>0.05). The ketorolac group experienced less tearing and photophobia only at 24 hr postoperatively (P=0.01), and by 72 hr after surgery, the results were similar in two groups (P>0.05). There was no significant intergroup difference in terms of foreign body sensation or blurred vision on the first or third postoperative days (P>0.05). Conclusions: Both diclofenac and ketorolac are effective in reducing pain and ocular discomfort after PRK, and ketorolac may have greater control on tearing and photophobia during the first 24 postoperative hours.