Management of pain with diclofenac after femtosecond-assisted laser in situ keratomileusis

PURPOSE: To evaluate the safety and efficacy of topical diclofenac sodium 0.1% after femtosecond laser assisted laser in situ keratomileusis (LASIK). SETTING: W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA. DESIGN: Clinical trial. METHODS: Pain was assessed in patients treated with topical diclofenac sodium 0.1% or artificial tears immediately after LASIK using a numeric pain scale and a combined picture numeric pain scale 0, 2, 4, 12, and 24 hours postoperatively. Visual outcomes and complications were noted up to 24 hours. RESULTS: The study enrolled 100 eyes of 50 patients. Patients treated with diclofenac 0.1% reported less pain than the control group on both pain scales 2, 4, 12, and 24 hours after surgery, with the maximum benefit at 4 hours (P = .02). Fewer patients in the diclofenac group (76.0%) than in the control group (91.3%) used oral pain and/or anxiolytic medications during the first 24 hours after surgery (P = .25). Ninety-eight eyes had an uncorrected distance visual acuity of 20/40 or better. Mild peripheral diffuse lamellar keratitis accounted for the majority of perioperative complications (n = 15). CONCLUSION: Pain after ferntosecond laser-assisted LASIK was mild and was reduced with a single dose of topical diclofenac sodium 0.1% given immediately after surgery.