To evaluate efficacy of several regimens in management of pain and early postoperative complications of patients following PRK.

In this double blind study, patients were randomized to five therapeutic groups: (1) oral naproxen (2) oral prednisolone with rapid dose reduction, (3) combination usage of topical ketorolac, (4) oral prednisiolone, and (5) combination of ketorolac and naproxen. Drug administration initiated after operation and lasted for two days. Subsequently, two days after the operation, ophthalmologists visited the participants (one hundred forty four patients) and completed the questionnaire which consisted of demographic features and scaling of ophthalmic indices. The patients were asked to subjectively assess ophthalmic indices such as pain (quantitative discrete scaling 0 to 10), photophobia (quantitative discrete scaling 0 to 4), and functional activity (quantitative discrete scaling 1 to 3). Surgeons were asked to objectively measure other scorings such as eyelid edema (quantitative discrete scaling 0 to 3) and conjunctival injection (quantitative discrete scaling 0 to 4) which questionnaire was assessed by precious studies

In our study, topical ketorolac was more effective than oral prednisolone in pain scoring (p-value: 0.015), eyelid edema (p-value< 0.001), and photophobia (p-value: 0.004). On the other hand, topical ketorolac was more effective than oral naproxen to control photophobia (p-value: 0.023), and naproxen was more effective than prednisolone to control eyelid edema (p-value: 0.006).

According to the trend to use NSADIs and to perform PRK, and the results of this study, we suggest that both systemic and topical agents be used after photorefractive keratectomy to control its post-operative complications. It also seems that topical ketorolac plus oral naproxen could be a good choice to reduce postoperative PRK complications.