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The Effect of Diclofenac Sodium Combined with Vitamin C for Relieving Discomfort after TPRK |
Haiyan Wang, Qingqing Feng, Jiafan Zhang, Wenzhi Ding, Yusu Peng, Keli Long |
Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China |
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Abstract Objective: To evaluate the clinical effect of diclofenac sodium combined with vitamin C to relieve discomfort after transepithelial photorefractive keratometry (TPRK). Methods: In this randomized control trial, seventy patients undergoing TPRK surgery were recruited from February to June 2018 and divided into observation group and control group, with 35 patients in each group. The observation group was treated with diclofenac sodium eyedrops combined with oral vitamin C, and the control group was treated only with diclofenac sodium eye drops. Symptoms and signs were observed on day 1, day 3 and day 4 after surgery, and eye irritation symptoms were evaluated by a questionnaire, including pain, foreign body feelings, tearing, photophobia, and discomfort in blinking. The results were analyzed with an unpaired t test and repeated measures ANOVA. Results: There were statistically significant differences between the two groups (pain score: F=10.219, P=0.002; foreign body feelings score: F=8.637, P=0.005; tearing: F=5.108, P=0.027. Repeated measures ANOVA). There were statistically significant differences for the above scores between the two groups on day 0 and day 1 after surgery (all P<0.05), but no statistically significant differences on day 2. The differences between the two groups were not statistically significant (photophobia score: F=3.626, P=0.061; discomfort score in blinking: F=2.778, P=0.100). But there were statistically significant differences between the two groups in the total discomfort score (F=7.785, P=0.001). Conclusion: Diclofenac sodium combined with vitamin C can relieve pain after TPRK surgery and reduce discomfort in patients.
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Received: 19 February 2019
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Fund: Key Research and Development Projects of Shanxi Province (201803D31018) |
Corresponding Authors:
Qingdao Eye Hospital, State Key Laboratory Cultivation Base, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao 266071, China (Email: longkeli2002@aliyun.com)
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[1] |
王勤美, 许琛琛. 激光表层角膜屈光手术的回归. 中华眼视光学与视觉科学杂志, 2015, 17(12): 708-711. DOI: 10.3760/cma. j.issn.1674-845X.2015.12.002.
|
[2] |
张钰, 陈跃国. 当代准分子激光角膜表层消融术. 中华眼视光学与视觉科学杂志, 2016, 18(2): 65-68. DOI: 10.3760/cma.j. issn.1674-845X.2016.02.001.
|
[3] |
徐婧, 李莹, 王忠海, 等. 经上皮准分子激光角膜切削术治疗近视的临床疗效. 中华眼视光学与视觉科学杂志, 2015, 17(12): 717-721. DOI: 10.3760/cma.j.issn.1674-845X.2015.12.004.
|
[4] |
董媛, 张钰, 夏英杰, 等. 0.1%溴芬酸钠水合物滴眼液减轻LASEK术后眼部刺激症状的疗效观察. 中华眼科杂志, 2015, 51(1): 51-54. DOI: 10.3760/cma.j.issn.0412-4081.2015.01.012.
|
[5] |
王晓瑛, 周行涛, 戴锦晖, 等. 普拉洛芬滴眼液控制准分子激光上皮角膜磨镶术后反应的临床评价. 眼视光学杂志, 2004, 6(3): 150-152. DOI: 10.3760/cma.j.issn.1674-845X.2004.03.005.
|
[6] |
Eslampoor A, Ehsaei A, Abrishami M. Effect of topical diclofenac on postoperative photorefractive keratectomy pain: a randomized, controlled trial. Clin Exp Ophthalmol, 2014, 42(9): 810-814. DOI: 10.1111/ceo.12343.
|
[7] |
Candelario-Jalil E, Akundi RS, Bhatia HS, et al. Ascorbic acid enhances the inhibitory effect of aspirin on neuronal cyclooxygenase-2-mediated prostaglandin E2 production. J Neuroimmunol, 2006, 174(1-2): 39-51. DOI: 10.1016/j. jneuroim.2006.01.003.
|
[8] |
Li R, Shen L, Yu X, et al. Vitamin C enhances the analgesic effect of gabapentin on rats with neuropathic pain. Life Sci, 2016, 157(7): 25-31. DOI: 10.1016/j.lfs.2016.05.035.
|
[9] |
Woreta FA, Gupta A, Hochstetler B, et al. Management of postphotorefractive keratectomy pain. Surv Ophthalmol, 2013, 58(6): 529-535. DOI: 10.1016/j.survophthal.2012.11.004.
|
[10] |
Fay J, Juthani V. Current trends in pain management after photorefractive and phototherapeutic keratectomy. Curr Opin Ophthalmol, 2015, 26(4): 255-259. DOI: 10.1097/ICU. 0000000000000170.
|
[11] |
Golan O, Randleman JB. Pain management after photorefractivekeratectomy. Curr Opin Ophthalmol, 2018, 29(4): 306-312. DOI: 10.1097/ICU.0000000000000486.
|
[12] |
赵家良, 黎晓新, 董冬生, 等.普拉洛芬滴眼液治疗白内障术后炎症和非感染性眼前段炎症的临床评价. 眼科研究, 2000, 18(6): 560-564. DOI: 10.3760/cma.j.issn.2095-0160.2000.06. 027.
|
[13] |
Luger MH, Ewering T, Arba-Mosquera S. Consecutive myopia correction with transepithelial versus alcohol-assisted photorefractive keratectomy in contralateral eyes: one-year results. J Cataract Refract Surg, 2012, 38(8): 1414-1423. DOI: 10.1016/j.jcrs.2012.03.028.
|
[14] |
赵丹丹, 赵广华, 黄蓓, 等. LASEK和TPRK治疗低中度近视的疗效对比. 中华眼视光学与视觉科学杂志, 2015, 17(12): 722-725. DOI: 10.3760/cma.j.issn.1674-845X.2015.12.005.
|
[15] |
赵炜, 董泽红, 师蓉, 等. TransPRK和LASEK术后恢复的对比研究. 中华眼视光学与视觉科学杂志, 2017, 19(5): 296-300. DOI: 10.3760/cma.j.issn.1674-845X.2017.05.008.
|
[16] |
Wang D, Chen G, Tang L, et al. Comparison of postoperative pain following laser-assisted subepithelial keratectomy and transepithelial photorefractive keratectomy: a prospective, random paired bilateral eye study. Eye Sci, 2014, 29(3): 155- 159. DOI: 10.3969/j.issn.1000-4432.2014.03.006
|
[17] |
Zeng Y, Li Y, Gao JH. Application of cold patch in relieving pain after transepithelial photorefractive keratectomy. Pain Res Manag, 2015, 20(4): 195-198. DOI: 10.1155/2015/850245.
|
[18] |
Zarei-Ghanavati S, Nosrat N, Morovatdar N, et al. Efficacy of corneal cooling on postoperative pain management after photorefractive keratectomy: A contralateral eye randomized clinical trial. J Curr Ophthalmol, 2017, 29(4): 264-269. DOI: 10. 1016/j.joco.2017.04.004.
|
[19] |
Mohammadpour M, Jabbarvand M, Nikdel M, et al. Effect of preemptive topical diclofenac on postoperative pain relief after photorefractive keratectomy. J Cataract Refract Surg, 2011, 37(4): 633-7. DOI: 10.1016/j.jcrs.2010.10.040.
|
[20] |
Mohammadpour M, Heidari Z, Molani R. Comparison between diclofenac and ketorolac ophthalmic drops for pain management after photorefractive keratectomy: A randomized clinical study[J]. Eye Contact Lens, 2019, 45(2): 137-140. DOI: 10.1097/ ICL.0000000000000524.
|
[21] |
Hsu JK, Johnston WT, Read RW, et al. Histopathology of corneal melting associated with diclofenac use after refractive surgery. J Cataract Refract Surg, 2003, 29(2): 250-256. DOI: 10. 1016/S0886-3350(02)01702-9.
|
|
|
|