Acta Scientific Ophthalmology (ISSN: 2582-3191)

Research Article Volume 6 Issue 4

Postoperative Pain Control in Femto-Lasik with the Use of Therapeutic Contact Lenses Soaked in Ketorolac Trometamol 0.45% TCL Soaked in Ketorolac for Pain After Femto-Lasik

Lorena Figueiredo Patricio1*, Renata Leite de Pinho Tavares2, Ramon Coral Ghanem2 and Vinícius Coral Ghanem3

1Fellow in Refractive Surgery at Sadalla Amin Ghanem Eye Hospital - Joinville/SC, Brazil
2Ophthalmologist at Sadalla Amin Ghanem Eye Hospital - Joinville/SC, Brazil
3Ophthalmologist and Medical Director at Sadalla Amin Ghanem Eye Hospital - Joinville/SC, Brazil

*Corresponding Author: Lorena Figueiredo Patricio, Fellow in Refractive Surgery at Sadalla Amin Ghanem Eye Hospital - Joinville/SC, Brazil.

Received: February 27, 2023; Published: March 17, 2023

Abstract

Objective: To compare the postoperative pain between patient eyes submitted to femtosecond laser-assisted LASIK after placement of contact lens (TCL) soaked in 0.45% ketorolac trometamol in one eye and placement of a TCL not soaked in the drug solution in the contralateral eye.

Setting: Sadalla Amin Ghanem Eye Hospital in Joinville, SC, Brazil.

Design: A double-blind, randomized, contralateral, prospective clinical study.

Methods: Patients submitted to LASIK with femtosecond laser received the TCL soaked in ketorolac trometamol 0.45% (Acular® CMC, Allergan, Inc., Irvine, CA) in one eye and a TCL without any medication in the other eye. The laterality selection was done randomly through a drawing. Patients with ocular surface diseases or those on chronic pain medication were excluded. The pain sensation was registered by the patients during 3 postoperative periods. The Wong-Baker Faces pain rating scale (from 0 to 10) was used.

Results: The study involved 64 eyes from 32 patients. The average postoperative pain score 3 hours after surgery in the eyes with TCL + ketorolac was 1.47 ± 2.12, significantly lower than the score among the eyes that received just the TCL, which was 3.31 ± 2.73 (P = 0.004). No statistically significant difference for pain level was observed 6 hours after surgery (P =0.053) and upon awakening the next day (P = 0.081).

Conclusion: The use of TCL soaked in ketorolac trometamol 0.45% safely provides significant pain reduction three hours after femto-LASIK when the pain is most intense.

 Keywords: Pain; LASIK; Femtosecond Laser; Ketorolac; Contact Lenses

References

  1. Kim SJ., et al. “Nonsteroidal anti-inflammatory drugs in ophthalmology”. Survey on Ophthalmology2 (2010): 108-133.
  2. Acular LS. ® [package insert]. Irvine, CA: Allergan, Inc.; (1997).
  3. Donnenfeld ED., et al. “Preoperative ketorolac tromethamine 0.4% in phacoemulsification outcomes: pharmacokinetic-response curve”. Journal of Cataract and Refractive Surgery9 (2006): 1474-1482.
  4. Perry HD and Donnenfeld ED. “An update on the use of ophthalmic ketorolac tromethamine 0.4%”. Expert Opinion on Pharmacotherapy1 (2006): 99-107.
  5. Price FW Jr., et al. “Pain reduction after laser in situ keratomileusis with ketorolac tromethamine ophthalmic solution 0.5%: a randomized, double-masked, placebo-controlled trial”. Journal of Refractive Surgery2 (2002): 140-144.
  6. Price MO and Price FW. “Efficacy of topical ketorolac tromethamine 0.4% for control of pain or discomfort associated with cataract surgery”. Current Medical Research and Opinion 12 (2004): 2015-2019.
  7. Sandoval HP., et al. “Evaluation of 0.4% ketorolac tromethamine ophthalmic solution versus 0.5% ketorolac tromethamine ophthalmic solution after phacoemulsification and intraocular lens implantation”. Journal of Ocular Pharmacology and Therapeutics 4 (2006): 251-257.
  8. Solomon KD., et al. “Safety and efficacy of ketorolac tromethamine 0.4% ophthalmic solution in postphotorefractive keratectomy patients”. Journal of Cataract and Refractive Surgery8 (2004): 1653-1660.
  9. ® LS [package insert]. Irvine, CA: Allergan, Inc.; (2008).
  10. Attar M., et al. “Farmacocinética ocular de 0,45% de cetorolaco de trometamina”. Clinical Ophthalmology 4 (2010): 1403-1408.
  11. Shetty R., et al. “Pain management after photorefractive keratectomy”. Journal of Cataract and Refractive Surgery 7 (2019): 972-1076.
  12. Xu K., et al. “Ex vivo corneal epithelial wound healing following exposure to ophthalmic nonsteroidal anti-inflammatory drugs”. Clinical Ophthalmology 5 (2011): 269-274.
  13. Maulvi FA., et al. “Drug Delivery A review on therapeutic contact lenses for ocular drug delivery”. 8 (2016): 3017-3026.
  14. Netto MV., et al. “Censo Brasileiro de Cirurgia Refrativa”. Arquivos Brasileiros de Oftalmologia1 (2013): 29-32.
  15. Huhtala A., et al. “Femtosecond lasers for laser in situ keratomileusis: a systematic review and meta-analysis”. Clinical Ophthalmology 10 (2016): 393-404.
  16. Pallikaris IG., et al. “Laser in situ keratomileusis”. Lasers in Surgery and Medicine5 (1990): 463-468.
  17. Baker CM and Wong DL. “QUEST: A process of pain assessment in children”. Orthopaedic Nursing1 (1987): 11.20.
  18. Lim Li., et al. “Therapeutic Contact Lenses in the Treatment of Corneal and Ocular Surface Diseases—A Review”. Asia-Pacific Journal of Ophthalmology6 (2021): 524-532.
  19. Li CC and Chauhan A. “Modeling ofthalmic drug delivery by contact lens bundle”. Industrial and Engineering Chemistry Research 45 (2006): 3718-3734.
  20. Li CC and Chauhan A. “Ocular transport model for ophthalmic delivery of timolol through contact lenses p-HEMA”. Journal of Drug Delivery Science and Technology 17 (2007): 69-79.
  21. J Chauhan A. “Dexamethasone transport and ocular delivery from poly (hydroxyethyl methacrylate) gels”. International Journal of Pharmaceutics 353 (2008): 205-222.
  22. Dougherty PJ. “Acular LS before and during LASIK for the control of pain: a randomized, masked contralateral eye trial”. Journal of Refractive Surgery 25 (2009): 210-213.
  23. Cleaveland NA., et al. “Efficacy and perioperative timing of bromfenac in the management of ocular discomfort after femtosecond laser-assisted laser in situ keratomileusis”. Journal of Cataract and Refractive Surgery2 (2017): 183-188.
  24. Zhao LQ., et al. “Bandage Contact Lens Application Reduces Fibrotic Wound Healing of Flap Margins after FS-LASIK: A Prospective Randomized Clinical Trial”. Journal of Ophthalmology (2019): 1-10.
  25. Pahlitzsch T., et al. “LenSx®-Femto-LASIK, FEMTO LDV Z4®-Femto-LASIK und PRK: Vergleich refraktiver Ergebnisse und Komplikationsanalyse”. Der Ophthalmologe (2017): 115.

Citation

Citation: Lorena Figueiredo Patricio., et al. “Postoperative Pain Control in Femto-Lasik with the Use of Therapeutic Contact Lenses Soaked in Ketorolac Trometamol 0.45% TCL Soaked in Ketorolac for Pain After Femto-Lasik".Acta Scientific Ophthalmology 6.4 (2023): 18-23.

Copyright

Copyright: © 2022 Lorena Figueiredo Patricio., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate35%
Acceptance to publication20-30 days
ISI- IF1.042
JCR- IF0.24

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