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Year : 2018  |  Volume : 19  |  Issue : 4  |  Page : 221-227

The effect of topical 1% nalbuphine versus 0.1% nepafenac on corneal epithelial wound healing and pain after photorefractive keratectomy

1 Department of Ophthalmology, Zagazig University, Zagazig, Egypt
2 Department of Anesthesia and Intensive Care, Zagazig University, Zagazig, Egypt

Correspondence Address:
Basem M Ibrahim
Department of Ophthalmology, Faculty of Medicine, Zagazig University, Zagazig 44519
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/DJO.DJO_18_18

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Purpose To compare nalbuphine 1% (opioid analgesic) eye drops and nepafenac 0.1% (NSAID) eye drops in terms of their effects on corneal re-epithelialization and pain after photorefractive keratectomy (PRK). Design A randomized prospective double-masked contralateral eye study was conducted. Patients and methods Thirty adult healthy patients who were undergoing bilateral PRK received nepafenac 0.1% eye drops in one eye and nalbuphine 1% eye drops in the contralateral eye, every 2 h on the day of surgery and then four times daily on postoperative days 1 through 5 after bandage contact lens insertion. Patients were asked to fill out pain assessment questionnaires every 2 h (general pain and after-drop pain) starting right away after surgery and continuing through postoperative day 5. Postoperative follow-up visits were daily until the epithelial defect completely healed in both eyes. The patients were then examined weekly for 4 weeks. At each visit, the patients provided rating of the general pain and the after-drop pain, and the epithelial defect size was assessed until complete healing of the corneal epithelium. Results The general pain scores were less and the after-drop pain scores were more in the nalbuphine group when compared with the nepafenac group, but with no statistically significant difference between them (P>0.05). The mean epithelial defect size was similar between nepafenac 0.1% and nalbuphine 1% eye drops at the procedure day, but there were statistically significant differences between them with more fast healing in the nalbuphine group from the first postoperative day until complete epithelial defect healing (P<0.05). Conclusion Nalbuphine 1% eye drops may provide a new choice in controlling pain after PRK surgery with comparable efficacy and better epithelial healing when compared with nepafenac 0.1% eye drops.

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