Pain management after photorefractive keratectomy

Rohit Shetty, Ritika Dalal, Archana Padmanabhan Nair, Pooja Khamar, Sharon D'Souza*, Ravish Vaishnav

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

17 Citations (Web of Science)


Purpose: To evaluate the effect of a bandage contact lens soaked in ketorolac ophthalmic 0.45% solution (Acuvail) on pain modulation in patients having transepithelial photorefractive keratectomy (PRK).

Design: Prospective case series.

Setting: Narayana Nethralaya Superspeciality Eye Hospital, Bangalore, India.

Methods: Eyes of patients were divided into 2 groups. After transepithelial PRK, a regular soft bandage contact lens was placed in Group 1 and a ketorolac-soaked bandage contact lens was placed in Group 2. The patients were matched for age and sex in the 2 groups. Postoperative pain was compared using the validated Wong-Baker pain scale. Before placement of a ketorolac-soaked bandage contact lens in patients' eyes, the safety of the procedure was checked using cultures from the bandage contact lens and measuring the quantity of the drug adsorbed and the elution profile over time with ultra-high-performance liquid chromatography (UHPLC).

Results: Each group comprised 35 eyes of 35 patients. The mean pain score was 7.95 +/- 2.12 (SD) in Group 1, which was significantly higher than in Group 2 (2.76 +/- 0.85), which received the ketorolac-soaked bandage contact lens. The UHPLC results showed that the soaked bandage contact lens acted as a depot for ketorolac, which was released onto the ocular surface over time, providing postoperative pain relief without causing adverse events.

Conclusion: A bandage contact lens soaked in ketorolac 0.45% solution can act as a potential drug depot that can reduce pain after transepithelial PRK. (C) 2019 ASCRS and ESCRS

Original languageEnglish
Pages (from-to)972-976
Number of pages5
JournalJournal of Cataract and Refractive Surgery
Issue number7
Publication statusPublished - Jul 2019


  • PRK

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