Efficacy of diclofenac sodium in treating post-penetrating keratoplasty pain and inflammation in patients with keratoconus

Purpose: To evaluate the efficacy of diclofenac sodium (DfNa) in treating pain and inflammation after penetrating keratoplasty (PKP) in patients with keratoconus. Methods: A prospective randomized study was performed to identify differences between groups of patients with keratoconus treated with or without DfNa in subjective symptoms (pain, difficulty of lid opening, lacrimation, foreign body sensation) and objective findings (hyperemia, tenderness, anterior chamber inflammation, width of palpebral fissure, damage to the corneal epithelium) on day 1 and day 5 after PKP. The dosage of DfNa was 1 drop at the end of surgery. Results: A significant difference was found in hyperemia and inflammation on postoperative day 1. However, no significant difference was found in the subjective symptoms or in postoperative pain and other objective symptoms. Conclusions: The results of this study suggest that instillation of 1 drop of DfNa is effective in reducing inflammation after PKP in patients with keratoconus. However, a higher dosage needs to be considered for analgesic effects after surgery.