Effects of Topical Nepafenac on Corneal Epithelial Healing Time and Postoperative Pain After PRK: A Bilateral, Prospective, Randomized, Masked Trial

Purpose: To assess the effects of nepafenac on corneal epithelial healing time and pain control compared to placebo in patients undergoing photorefractive keratectomy (PRK) surgery. Methods: This randomized, double-masked, placebo-controlled, single-site study included 66 adults (132 eyes) undergoing bilateral PRK surgery. Patients received 1 drop three times daily of nepafenac 0.1% in one eye and balanced salt solution in the contralateral eye until the corneal epithelium healed. Postoperatively, patients were evaluated daily for the progression of epithelial healing until complete closure was observed. Patients also were asked daily to assess the level of pain in each eye using a visual analog scale of 0 to 10. Results: There was no statistical difference between treatments in time to epithelial healing. All patients healed by postoperative day 4. Patients receiving nepafenac reported significantly less pain on postoperative days 1 (0.76 versus 1.68) and 2 (1.26 versus 2.23) compared to placebo ( P <.0005). A greater percentage of patients also reported superior pain relief in the nepafenac-treated eye compared to the placebo eye during the first 3 days following surgery. Conclusions: Treatment with nepafenac 0.1% significantly reduced postoperative pain immediately following surgery and had no significant adverse effect on time to reepithelialization compared to placebo. [ J Refract Surg. 2008;24:377–382.]