The present study, which was designed as a prospective, double-masked, randomized, controlled, single-site study, was conducted to compare the effects of 3 approved ophthalmic nonsteroidal anti-inflammatory drugs-nepafenac ophthalmic suspension 0.1% (Nevanac; Alcon Laboratories, Inc., Fort Worth, Tex), ketorolac tromethamine ophthalmic solution 0.4% (Acular LS; Allergan, Irvine, Calif), and bromfenac 0.09% (Xibromtrade mark; ISTA Pharmaceuticals, Irvine, Calif)-on corneal reepithelialization and postoperative pain control in patients undergoing photorefractive keratectomy. In addition to nonsteroidal anti-inflammatory drugs, each patient received an antibiotic-moxifloxacin hydrochloride ophthalmic solution 0.5% (nepafenac group) or gatifloxacin ophthalmic solution 0.3% (ketorolac and bromfenac groups). All treatments were administered 3 times daily beginning 1 d preoperatively and continuing for 1 wk postoperatively; prednisolone acetate 1.0% was administered concurrently 4 times daily. Bandage contact lenses were replaced at each postoperative visit for corneal staining and epithelial defect grading. Self-evaluation of pain relief was recorded on postoperative days 1 and 3 with the use of a visual analog scale. A total of 29 patients (58 eyes) were enrolled and underwent bilateral custom photorefractive keratectomy. Mean time to reepithelialization was 5.50+/-1.59 d for the nepafenac 0.1% group, 5.62+/-1.23 d for the ketorolac 0.4% group, and 7.25+/-2.53 d for the bromfenac 0.09% group. A significant difference was detected between nepafenac 0.1% and bromfenac 0.09% and between ketorolac 0.4% and bromfenac 0.09% (P<.05). Significant reductions in pain scores were observed with nepafenac 0.1% on day 1 (-1.13) and day 3 (-1.32), ketorolac 0.4% on day 3 (-0.88), and bromfenac 0.09% on day 3 (-0.83). No adverse events were reported. Eyes treated with nepafenac 0.1% or ketorolac 0.4% achieved complete reepithelialization significantly faster than those treated with bromfenac 0.09%. Daily contact lens removal and application of fluorescein may have delayed reepithelialization in the overall population; however, the effect would have been the same in all 3 groups. Pain relief with nepafenac 0.1% was achieved sooner than with ketorolac 0.4% or bromfenac 0.09%.

PURPOSE: Anterior segment optical coherence tomography (OCT) was used to analyze thin flaps created with the IntraLase femtosecond laser (IntraLase Corp). METHODS: Twenty-five eyes of 25 patients had flaps created with the 60 kHz IntraLase femtosecond laser prior to excimer laser ablation. The desired flap thickness was 110 microm with a diameter of 8.5 mm for all eyes. At 1 month postoperatively, all eyes were evaluated with the Visante anterior segment OCT (Carl Zeiss Meditec). Four thickness measurements were obtained across the length of the flaps at the meridians of 45 degrees, 90 degrees, 135 degrees, and 180 degrees. Thus, 16 thickness measurements were analyzed for each flap. RESULTS: Flaps were uniform (planar) with a mean thickness of 112 +/- 5 microm (range: 87 to 118 microm). Average standard deviation within the individual flaps was 4 microm (range: 1 to 8 microm). CONCLUSIONS: The IntraLase femtosecond laser creates thin, uniform (planar) flaps with high predictability and reproducibility.