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Juan Carlos Serna-Ojeda, Omar Santana-Cruz, Natalia Quiroz-Casian, José Luis Mercado-Orozco, Jesus Cabral, Valeria Oliva-Biénzobas, Arturo J Ramirez-Miranda, Alejandro Navas, Alejandro Lichtinger, Enrique O Graue-Hernandez; Pain management in corneal collagen crosslinking for keratoconus: A prospective randomized study.. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5682.
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To assess pain control in patients assigned to either oral ketorolac 10-mg every 8 hours or gabapentin 300-mg every 8 hours after corneal collagen crosslinking (CXL) for progressive keratoconus.
Using a validated numeric analogue scale, questionnaire scores for pain, related symptoms and side effects were assessed two hours after the surgery, and at postoperative days one to five. Inclusion criteria were patients with keratoconus, older than 18 years with confirmed bilateral progression. Outcomes were compared using Wilcoxon rank-sum (Mann-Whitney) test and a median regression to estimate the effect of covariates on severity of pain, with significance considered when p<0.05.
Twenty-five patients were included, with a median age of 23 years (range 18 to 30 years); 13 randomized to the ketorolac group and 12 to the gabapentin group. The distribution of the epithelium-on and epithelium-off procedures were as follow: in the gabapentin group, 5 epithelium-on and 7 epithelium-off; in the ketorolac group, 4 epithelium-on and 9 epithelium-off. No statistically significant differences were noted on the pain scale between groups at any point of the study (p values range from 0.16 to 0.91). The regression analysis showed no effect of the type of surgery (epithelium-on or epithelium-off) or gender in the severity of pain at any point of follow-up.
Both ketorolac and gabapentin can be used with similar results for pain and symptomatic control after CXL.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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