A comparative study on the role of nepafenac as a therapy component in patients after Femto-LASIK

Introduction. The number of patients with refraction disorders has increased significantly over the past decade, which led to a high rise in keratorefractive laser surgeries. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in ophthalmological practice appears to be a topical issue in patients who have undergone various keratorefractive surgeries.

Aim. To evaluate the clinical and pathogenetic efficacy of nepafenac as part of postoperative therapy in patients after Femto LASIK.

Materials and methods. The study included 120 patients (240 eyes) who have undergone a two-step Femto LASIK laser vision correction due to myopia, myopic, and mixed astigmatism. Patients were divided into two comparable groups: a treatment group, who received nepafenac in addition to standard therapy in the postoperative period, and a control group, who received standard therapy without nonsteroidal anti-inflammatory drugs. All patients underwent cornea optical coherence tomography (OCT) with epithelial and pachymetric mapping, as well as measurements of interleukin-6 and interleukin-8 concentrations in tear fluid using enzyme-linked immunosorbent assay. The laser confocal microscopy scans were performed to evaluate corneal nerves and epithelium.

Results and discussion. In the control group, we observed significantly higher levels of proinflammatory cytokines and incidence of epithelial instability on Day 1 after surgery. In the group of patients receiving Apfecto, interleukin-6 levels were 42% lower, and only 32% of patients displayed a great heterogeneity at the level of epithelial profile. By Days 5–7, uniform epithelial restoration was noted in 88% of patients in the treatment group versus 63% in the control group (p ≤ 0.05). The corneal confocal microscopy showed that corneal epithelium and nerve fiber status was consistent across both groups at all follow-up points.

Conclusions. The introduction of the pro-NSAID nepafenac in the postoperative treatment regimen after Femto LASIK is accompanied by significantly reduced inflammatory activity, as well as more stable and predictable corneal restoration.

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