Comparison of Nepafenac 0.1% and Ketorolac 0.4% in Postoperative Healing in EpiLASIK Patients

1
Comparison of Nepafenac 0.1 and Ketorolac 0.4
in Postoperative Healing in Epi-LASIK Patients

• Rolando Toyos, MD
• Toyos Clinic, Jackson, TN, USA

2
Introduction

• Nevanac (Nepafenac 0.1) and Acular LS (Ketorolac
  0.4) are ophthalmic NSAIDs that are used for the
  reduction of ocular pain following corneal
  refractive surgery

3
Purpose

• To compare nepafenac 0.1 and ketorolac 0.4 for
  their effects on corneal epithelial healing
  following Epi-LASIK surgery

4
Methods

• Double-masked, contralateral eye-controlled,
  randomized study
• Patients corneal epithelium was removed with an
  epi-keratome and discarded
• Laser ablation was performed with an 8.0 mm
  ablation zone
• A drop of moxifloxacin 0.5 and prednisolone
  acetate 1.0 were placed on the eye

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Methods (continued)

• A bandage contact lens was applied, and patients
  were administered the following medications until
  removal of the contact lens
• Moxifloxacin 0.5 QID
• Prednisolone acetate 1.0 TID
• Preservative-free artificial tears PRN, up to one
  drop per hour
• Either nepafenac 0.1 TID or ketorolac 0.4 TID,
  depending on randomization
• Following surgery, the patients received punctal
  plugs

6
Results

• 11 patients were enrolled in this contralateral
  eye-controlled study (N22 eyes)
• Mean age was 30.91 years (range 25 37)
• No statistical differences were observed for
• Mean preoperative refraction (p0.4098)
• Nepafenac 0.1 -4.75 2.69D
• Ketorolac 0.4 -5.05 2.82D
• Microns removed (p0.2982)
• Nepafenac 0.1 64.71 26.11mm
• Ketorolac 0.4 68.56 28.06mm
• Cylinder (p0.4198)
• Nepafenac 0.1 -1.20 1.17D
• Ketorolac 0.4 -1.11 1.00D

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Visual Acuity
p values at each time point gt 0.2908
Baseline visual acuity was similar between groups
(p.3981)
8
Haze
p 0.3409



Statistical comparison was invalid since
between-eye difference was 0 for all patients
9
Corneal Epithelial Healing
p 0.3409
10
Conclusions

• Nepafenac 0.1 and ketorolac 0.4 produced
  similar rates of corneal epithelial healing
  following Epi-LASIK

11
Disclosures

• This poster contains information about off-label
  NSAID use