Ointment prevents postop pain after PRK, surgeon says

THOROFARE, N.J. — Postoperative pain after photorefractive keratectomy can be prevented by protecting the stroma with ointment, according to Barbara Parolini, MD, of Verona, Italy.

Dr. Parolini’s recent findings will be featured in the October 15, 2001, edition of Ocular Surgery News.

Because pain is a deterrent for many patients who may want to choose PRK as their refractive surgery procedure, Dr. Parolini embarked on an effort to find a new and effective method to prevent pain.

She explained that LASIK is a near-painless procedure in many patients because the epithelium is minimally disrupted; the stromal flap is placed back without displacement of the epithelium. However, with PRK even with a bandage contact lens, the regrowth of epithelium over the bared stroma can be painful.

Dr. Parolini performed a prospective study in which 30 patients underwent bilateral surgery using a standard technique for PRK. At the end of the procedure she placed the usual drops of antibiotic and nonsteroidal anti-inflammatory drug in one eye. In the other eye she used an ointment containing substances that facilitate re-epithelialization, such as tetracycline, xantopterin and retinol, plus an antibiotic and a bandage contact lens.

Patients reported that the ointment-treated eyes had less pain than the non-ointment eyes. The results were even better when she asked the patients to use the ointment on the ointment-treated eye on successive days until the bandage contact lens was removed.