Table 1_Clinical outcomes and safety of preservative-free diclofenac sodium eye drops in SPT-assisted transepithelial photorefractive keratectomy.docx

BackgroundEarly postoperative pain and epithelial recovery remain important determinants of patient experience after surface ablation refractive surgery. Evidence comparing topical nonsteroidal anti-inflammatory drug (NSAID) options in Smart Pulse Technology (SPT)-assisted transepithelial photorefractive keratectomy (TransPRK) is limited.
MethodsThis retrospective cohort study included consecutive patients who underwent SPT-assisted TransPRK between January 2022 and December 2025. Patients received either standard postoperative care plus pranoprofen 0.1% eye drops (control group) or preservative-free diclofenac sodium 0.1% eye drops (PF diclofenac; observation group), administered four times daily for 3 days. Pain was assessed using the visual analog scale (VAS; 0–10) at 2, 24, 48, and 72 h. Secondary outcomes included time to complete epithelialization, time to bandage contact lens (BCL) removal, corneal haze grading, ocular surface and inflammatory signs, and adverse events.
ResultsA total of 239 patients were analyzed (control, n = 118; observation, n = 121). The observation group had significantly lower VAS pain scores at 2 h (5.40 ± 1.70 vs. 4.80 ± 1.60; P = 0.005), 24 h (4.20 ± 1.60 vs. 3.40 ± 1.50; P < 0.001), 48 h (2.80 ± 1.30 vs. 2.10 ± 1.20; P < 0.001), and 72 h (1.60 ± 1.00 vs. 1.20 ± 0.90; P = 0.001). A higher proportion of patients in the observation group achieved mild pain (VAS ≤ 3) at 24 h (53.7% vs. 38.1%; P = 0.016). Time to complete epithelialization (4.05 ± 0.88 vs. 4.32 ± 0.92 days; P = 0.021) and BCL removal (4.25 ± 0.90 vs. 4.56 ± 0.98 days; P = 0.012) were shorter in the observation group. Corneal haze and adverse events were comparable between groups, and no serious adverse events were observed.
ConclusionIn SPT-assisted TransPRK, PF diclofenac was associated with improved early pain control and modestly faster epithelial recovery, without detectable differences in haze or short-term safety compared with pranoprofen.