Use of Topical Nonsteroidal Anti-inflammatory Drugs after Photorefractive Keratectomy

BACKGROUND: Photorefractive keratectomy (PRK) requires a careful pharmacologic regimen during the postoperative period to reduce corneal haze and refractive myopic regression. Noncorticosteroidal anti-inflammatory drugs limit postablative corneal inflammation without the complications that may occur during corticosteroid treatment. METHODS: Twenty consecutive eyes of 10 patients with attempted correction ranging from 4.00 to 9.00 D of myopia were studied. During the postoperative period, corticosteroid drops (dexamethasone 0.1%) were instilled in the first eye of each patient, and the second eye was treated with diclofenac sodium ophthalmic solution 0.1% (Voltaren). Follow-up was 12 months after surgery. RESULTS: Corneal haze and refraction were studied. Six of the 10 eyes treated with noncorticosteroidal anti-inflammatory drugs did not show any significant difference in corneal haze and refractive evolution compared to the contralateral eyes treated with corticosteroids. Two eyes (20%) showed less corneal haze and more refractive stability than the contralateral eyes. In two eyes (20%), we observed similar corneal haze but more refractive regression than in the contralateral eyes. CONCLUSIONS: Eyes treated with topical diclofenac sodium had a similar postoperative course as those treated with corticosteroids, but without the adverse effects of corticosteroids. Topical nonsteroidal anti-inflammatory drugs are represented by diclofenac (Voltaren), which has significant ocular penetration. This permits reduction of the possibility of general and ocular complications that frequently occur with corticosteroids. The aim of this study was to evaluate the efficacy of topical nonsteroidal antiinflammatory drugs vs. corticosteroidal eyedrops after photorefractive keratectomy (PRK) to reduce moderate and high myopia.