Comparison of the Effects of Eight Different Topical Non-Steroidal Anti-Inflammatory Drugs on Reducing Intravitreal Injection-induced Pain.

Abstract

Purpose: To compare topical nonsteroidal anti-inflammatory drug (NSAID) efficacy on intravitreal injection (IVI)-induced pain reduction, and determine the most efficient topical NSAID. Methods: This randomized controlled study included 662 eyes of 662 patients. Based on the types of NSAID administered before IVI, eight subgroups were formed. In the control group, a sterile saline solution was applied instead of NSAIDs. The visual analog scale (VAS) was used to assess pain scores after IVI. The VAS scores were noted immediately and 6 hours following injection (6th hour). Results: Nepafenac 0.3%, 0.1%, and bromfenac had the lowest scores, immediately after and after 6 hours, with no significant differences. Diclofenac and ketorolac had higher VAS scores than the first trio but lower scores than the control group. Flurbiprofen, pranoprofen, and indomethacin did not significantly affect immediate pain; however, at the 6th hour, the VAS scores were significantly reduced. Conclusion: Nepafenac 0.3%, 0.1%, and bromfenac were the most effective NSAIDs for pain reduction. Although some NSAIDs did not have a significant effect on immediate pain, they all provided significant benefit at the 6th hour.