Abstract
Purpose :
Ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) have decreased pain and inflammation following ophthalmic procedures, including cataract and refractive surgery. Bromfenac has demonstrated particularly good ocular tissue penetration, augmenting its effect in treating pain and inflammation of more invasive ocular procedures. We performed a randomized, double-masked, single-center study of adults receiving bilateral intravitreal vascular endothelial growth factor injections (IVI) to compare the use of pre-injection bromfenac 0.09% ophthalmic solution in pain reduction over time.
Methods :
Patients receiving bilateral IVI at Wills Eye Hospital from March 2021 to June 2022 were randomized to receive bromfenac 0.09% solution in one eye and artificial tears in their fellow eye. As part of the standard IVI procedure, both eyes were prepared with proparacaine drops. Before injection, all patients quantified their typical IVI pain using the Wong-Baker FACES and the short-form McGill Pain Questionnaire. Following IVI, patient pain in each eye was assessed via the same questionnaire at three time points: five minutes, six hours, and one day after injection.
Results :
81 patients (162 eyes) were enrolled in the study. A paired T-test was performed on all patients with a typical IVI pain score of >0 (n=56/81 subjects) to compare the reduction of pain between the study (bromfenac) and the control eye. Five-minute post-IVI, patients reported a -.564 point pain reduction using the Wong-Baker FACES scale in the eye that received bromfenac 0.09% (p=0.041). However, there was no significant difference in pain reduction at six hours or one day post-IVI, nor was there significant pain reduction between the two groups at any time point when utilizing the short-form McGill Pain Questionnaire.
Conclusions :
Compared to the placebo, bromfenac 0.09% solution administered before IVI improved pain control five minutes after injection when quantified by the Wong-Baker FACES scale. However, while there was a trend in the reduction of pain in eyes receiving bromfenac as compared to the control, the difference was not clinically or statistically significant six hours and one day post-IVI.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.