Pregabalin Versus Placebo in Postoperative Pain Relief of Patients' Status Post Photorefractive Keratectomy: A Double-Masked, Randomized, Prospective Study

Purpose: Gabapentinoids are currently being used anecdotally for postoperative pain following photorefractive keratectomy (PRK) despite the lack of evidence. The purpose of this study is to evaluate the effectiveness of pregabalin in mitigating pain after PRK compared to the standard of care. Methods: One hundred thirty-five patients scheduled for PRK at the Joint Warfighter Refractive Surgery Center in San Antonio, Texas were randomized to receive either oral pregabalin 75 mg twice daily for 5 days or placebo, in addition to the standard pain care regimen. Results: There was no statistically significant difference in the primary outcome of 10% improvement in subjective pain scores between the treatment and placebo groups at any point during the postoperative period, but there was a trend for lower subjective pain scores in the pregabalin group. There was a statistically significant difference in the frequency of rescue pain medications used on postoperative days 1 and 2. The pregabalin group required an average of 1.7 doses of rescue medications on postoperative day 1 versus 2.4 doses in the placebo group, and 1.7 doses versus 2.6 doses on postoperative day 2 (P < 0.05). Conclusions: This study demonstrates that pregabalin may provide an alternative or add-on option to standard narcotics for pain relief after PRK.