Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
An Unusual Approach to Reduce Pain Following LASIK Surgery
LASIK Cerrahisi Sonrası Ağrıyı Azaltmak İçin Kullanılan Farklı Bir Yaklaşım
Fikret UÇARa, Servet ÇETİNKAYAa, Lütfi SEYREKa
aKonyagöz Hospital, Konya, TURKEY
Turkiye Klinikleri J Ophthalmol. 2021;30(2):92-6
doi: 10.5336/ophthal.2020-78412
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the effectiveness of topical 0.4% ketorolac tromethamine usage with contact lenses following laser-assisted in situ keratomileusis (LASIK) surgery, for post-operative pain reduction. Material and Methods: Two hundred and ninety two eyes of 146 patients who underwent LASIK surgery under topical anesthesia were included in the study. Contact lenses soaked in a 0.4% solution of ketorolac tromethamine were applied to 148 eyes of 74 patients who had undergone LASIK surgery for refractive errors (Group 1). Contact lenses with no medication were applied to 144 eyes of 72 patients who had undergone LASIK surgery for refractive errors (Group 2). Pain scores were recorded in both groups every hour from hour 1 to hour 5, postoperatively. Results: There were no significant differences between the two groups with regard to age or sex (p>0.05). No significant difference was found between the two groups in respect of either preoperative or postoperative mean uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and intraocular pressure values (p>0.05). The mean postoperative UCVA was significantly better than the mean preoperative UCVA in both groups (p<0.05). Pain scores for Group 1 patients at postoperative hours 2, 3, and 4 were significantly lower than for patients in Group 2 (p<0.001, p<0.001 and p=0.023, respectively). Topical ketorolac tromethamine did not negatively affect wound healing, corneal flap, or ocular surface in any patient. Conclusion: Topical ketorolac tromethamine application with contact lenses following LASIK surgery decreases pain and discomfort effectively.

Keywords: Ketorolac tromethamine; contact lens; keratomileusis, laser in situ; pain
ÖZET
 Amaç: Topikal %0,4 ketorolak trometaminin, 'laser-assisted in situ keratomileusis (LASIK)' ameliyatlarında operasyon sonrasında kontakt lens uygulaması ile birlikte kullanılmasının, postoperatif ağrıyı azaltmasındaki etkinliğini değerlendirmek. Gereç ve Yöntemler: Topikal anestezi uygulanarak, LASIK operasyonu geçiren 146 hastanın 292 gözü çalışmaya dâhil edilmiştir. Refraksiyon kusuru için LASIK cerrahisi uygulanan 74 hastanın 148 gözüne, %0,4 ketorolak trometaminde ıslatılan kontakt lensler uygulandı (1. Grup). Refraksiyon kusur için LASIK cerrahisi uygulanan 72 hastanın 144 gözüne ise kontakt lens uygulaması yapılırken herhangi bir damla damlatılmadı (2. Grup). Operasyon sonrası 1. Saatten itibaren başlayarak, 5. saate kadar her saat başı hastaların ağrı skorları kaydedildi. Bulgular: Yaş ve cinsiyet açısından iki grup arasında anlamlı bir farklılık yoktu (p>0,05). Ameliyat öncesi ve ameliyat sonrası ortalama düzeltilmemiş görme keskinliği (DGK), düzeltilmiş görme keskinliği (DÜGK) ve göz içi basıncı açısından anlamlı bir farklılık yoktu (p>0,05). Her iki grupta ameliyat öncesi DGK, ameliyat sonrası DGK'den anlamlı olarak daha yüksekti (p<0,05). Post-operatif 2, 3, 4 ve 5. saatlerdeki ağrı skorları Grup 1'deki hastalarda Grup 2'dekilere göre anlamlı olarak daha düşüktü (p değerleri sırasıyla p<0,001, p<0,001 ve p=0,023). Topikal ketorolak trometamin, hiçbir hastada yara iyileşmesini, korneal flebi ve oküler yüzeyi negatif yönde etkilemedi. Sonuç: Kontakt lens ile birlikte %0,4 ketorolak trometamin uygulanması, LASIK cerrahisi sonrasında ağrıyı ve rahatsızlığı etkin bir şekilde azaltmaktadır.

Anahtar Kelimeler: Ketorolak trometamin; kontakt lens; keratomilöz, lazer in situ; ağrı
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