• Se Kyung Kim, Jin Pyo Hong, Sang Min Nam, Robert Doyle Stulting, and Kyoung Yul Seo.
• From the Nune Eye Hospital (Kim), the Saeyan Eye Clinic (Hong), and the Department of Ophthalmology (Seo), Eye and Ear Hospital, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, and the Department of Ophthalmology (Nam), CHA Bundang Medical Center, CHA University, Seongnam, South Korea; the Stulting Research Center (Stulting), Woolfson Eye Institute, Atlanta, Georgia, USA.
• J Cataract Refract Surg. 2015 Apr 1;41(4):749-55.

PurposeTo assess the effect of preoperative topical nonsteroidal antiinflammatory drugs (NSAIDs) on postoperative pain after laser-assisted subepithelial keratectomy (LASEK) and to investigate their mechanism.SettingSeverance Eye Hospital and Saeyan Eye Clinic, Seoul, South Korea.DesignProspective randomized clinical trial.MethodsParticipants in 2 related studies were assessed. Study 1 comprised patients scheduled for bilateral LASEK (Group 1) who were randomized to receive an NSAID in 1 eye and a placebo in the fellow eye 30, 20, and 10 minutes before LASEK. Postoperative pain, glare, tearing, and irritation were assessed using a visual analog scale. Study 2 comprised healthy subjects (Group 2) who were randomly divided into subgroups. The participants in these subgroups were randomized to receive ketorolac tromethamine 0.5% in 1 eye and placebo (ofloxacin 0.3%) in the fellow eye (Group 2A), proparacaine hydrochloride 0.5% in 1 eye and placebo in the fellow eye (Group 2B), or ketorolac tromethamine 0.5% in 1 eye and placebo in the fellow eye, followed 10 minutes later by 1 drop of proparacaine hydrochloride 0.5% in both eyes (Group 2C). In all 3 groups, corneal sensitivity was measured after 1, 2, and 6 hours.ResultsThe mean postoperative pain score in the NSAID-pretreated eye was statistically significantly lower than in the placebo-pretreated eye 6, 12, and 24 hours postoperatively (P < .05). The mean corneal sensitivity was statistically significantly lower in the NSAID-treated eye than in the placebo-treated eye at 1 and 2 hours in Groups 2A and 2C (P < .05).ConclusionPreoperative administration of topical NSAIDs before LASEK effectively reduces postoperative pain.Financial DisclosureNo author has a financial or proprietary interest in any material or method mentioned.Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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