Acular LS Before and During LASIK for the Control of Pain: A Randomized, Masked Contralateral Eye Trial

Purpose: To assess the effect of ketorolac tromethamine 0.4% (Acular LS; Allergan Inc) drops in controlling LASIK pain. Methods: A prospective, randomized, double-masked, placebo-controlled study was performed to evaluate the effect of Acular LS on LASIK pain. Patients were given two unmarked bottles prior to surgery, one containing ketorolac tromethamine 0.4% (ketorolac group) and the other containing Refresh Tears (Tears group). Patients were randomly assigned to instill Acular LS in one eye and Refresh Tears in the fellow eye four times a day beginning 48 hours prior to LASIK, just before the keratome pass, and at the conclusion of surgery. Bilateral simultaneous LASIK was performed on the right eye followed by the left eye. Pain was assessed on a scale of 0 (no pain) to 6 (extreme pain) immediately after surgery on each eye and again 4 to 6 hours after surgery. Patients were evaluated at postoperative day 1 for microstriae and flap slips. Results: Sixty eyes of 30 patients were enrolled in the study. No eyes experienced postoperative flap slips or microstriae. The mean postoperative pain score in the Tears group of 1.23±1.33 was significantly higher ( P =.002) than the postoperative score of 0.53±0.86 in the ketorolac group. The mean intraoperative pain score in the Tears group of 1.43±1.31 was higher ( P =.085) than the intraoperative score of 0.97±1.16 in the ketorolac group. Conclusions: Pre- and intraoperative treatment with Acular LS significantly reduces postoperative LASIK pain. [ J Refract Surg . 2009;25:210–213.]