{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T06:47:27Z","timestamp":1776235647874,"version":"3.50.1"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 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\u00a0days. Pain was assessed using the visual analog scale (VAS; 0\u201310) at 2, 24, 48, and 72\u00a0h. 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 239 patients were analyzed (control, n = 118; observation, n = 121). The observation group had significantly lower VAS pain scores at 2\u00a0h (5.40 \u00b1 1.70 vs. 4.80 \u00b1 1.60; P = 0.005), 24\u00a0h (4.20 \u00b1 1.60 vs. 3.40 \u00b1 1.50; P &amp;lt; 0.001), 48\u00a0h (2.80 \u00b1 1.30 vs. 2.10 \u00b1 1.20; P &amp;lt; 0.001), and 72\u00a0h (1.60 \u00b1 1.00 vs. 1.20 \u00b1 0.90; P = 0.001). A higher proportion of patients in the observation group achieved mild pain (VAS \u2264 3) at 24\u00a0h (53.7% vs. 38.1%; P = 0.016). Time to complete epithelialization (4.05 \u00b1 0.88 vs. 4.32 \u00b1 0.92\u00a0days; P = 0.021) and BCL removal (4.25 \u00b1 0.90 vs. 4.56 \u00b1 0.98\u00a0days; 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1781133","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:45:39Z","timestamp":1776231939000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical outcomes and safety of preservative-free diclofenac sodium eye drops in SPT-assisted transepithelial photorefractive keratectomy"],"prefix":"10.3389","volume":"17","author":[{"given":"Huang","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Zhongshan Torch Development Zone People\u2019s Hospital","place":["Zhongshan, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zhongshan Torch Development Zone People\u2019s Hospital","place":["Zhongshan, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuang","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zhongshan Torch Development Zone People\u2019s Hospital","place":["Zhongshan, Guangdong, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"3025","DOI":"10.1007\/s40123-023-00791-0","article-title":"Preservative-free topical anesthetic unit-dose eye drops for the management of postoperative pain following photorefractive keratectomy","volume":"12","author":"Abdel-Radi","year":"2023","journal-title":"Ophthalmol. Ther."},{"key":"B2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s12886-024-03830-x","article-title":"Efficacy of single-step transepithelial photorefractive keratectomy in Myopia, hyperopia and astigmatism-a systematic review","volume":"25","author":"Akram","year":"2025","journal-title":"BMC Ophthalmol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"337","DOI":"10.4103\/ojo.ojo_212_23","article-title":"Early visual and clinical outcomes of transepithelial photorefractive keratectomy versus transepithelial keratectomy with smart pulse technology for myopia","volume":"17","author":"Alkadi","year":"2024","journal-title":"Oman J. Ophthalmol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1097\/j.jcrs.0000000000001525","article-title":"Topical nonsteroidal anti-inflammatory drugs for management of pain after PRK: systematic review and network meta-analysis","volume":"50","author":"Ben Ephraim Noyman","year":"2024","journal-title":"J. Cataract. Refract Surg."},{"key":"B5","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.ophtha.2023.02.016","article-title":"Ocular pain after refractive surgery: interim analysis of frequency and risk factors","volume":"130","author":"Betz","year":"2023","journal-title":"Ophthalmology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e001624","DOI":"10.1136\/bmjophth-2023-001624","article-title":"Prospective cohort study investigating frequency and risk factors for acute pain 1 day after refractive surgery","volume":"9","author":"Betz","year":"2024","journal-title":"BMJ Open Ophthalmol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"428","DOI":"10.1089\/jop.2024.0025","article-title":"Preventative effect of topical rebamipide against corneal epithelium disorders caused by diclofenac sodium","volume":"40","author":"Fukuda","year":"2024","journal-title":"J. Ocul. Pharmacol. Ther."},{"key":"B8","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1038\/s41433-021-01668-x","article-title":"Ocular benzalkonium chloride exposure: problems and solutions","volume":"36","author":"Goldstein","year":"2022","journal-title":"Eye (Lond)."},{"key":"B9","doi-asserted-by":"publisher","first-page":"3049","DOI":"10.1007\/s40123-024-01040-8","article-title":"Postoperative pain comparison between alcohol-assisted and transepithelial photorefractive keratectomy using nepafenac treatment: a novel study","volume":"13","author":"Gomel","year":"2024","journal-title":"Ophthalmol. Ther."},{"key":"B10","doi-asserted-by":"publisher","first-page":"4109","DOI":"10.3390\/jcm11144109","article-title":"A new postoperative regimen after CXL and PRK using topical NSAID and steroids on the open ocular surface","volume":"11","author":"Hafezi","year":"2022","journal-title":"J. Clin. Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"e91023","DOI":"10.7759\/cureus.91023","article-title":"Comparative efficacy of transdermal ketoprofen and diclofenac sodium in the management of post-endodontic pain: a prospective in vivo study","volume":"17","author":"Haque","year":"2025","journal-title":"Cureus"},{"key":"B12","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1186\/s12886-022-02293-2","article-title":"Comparison of transepithelial and conventional photorefractive keratectomy in myopic and myopic astigmatism patients: a randomized contralateral trial","volume":"22","author":"Hashemi","year":"2022","journal-title":"BMC Ophthalmol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"3058","DOI":"10.3390\/jcm13113058","article-title":"Clinical outcomes of transepithelial photorefractive keratectomy performed with smart pulse technology for the correction of moderate to high myopia","volume":"13","author":"Ho","year":"2024","journal-title":"J. Clin. Med."},{"key":"B14","doi-asserted-by":"publisher","first-page":"13267","DOI":"10.1038\/s41598-017-13122-8","article-title":"Non-steroidal anti-inflammatory drug delays corneal wound healing by reducing production of 12-hydroxyheptadecatrienoic acid, a ligand for leukotriene B(4) receptor 2","volume":"7","author":"Iwamoto","year":"2017","journal-title":"Sci. Rep."},{"key":"B15","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1055\/a-1739-0410","article-title":"Efficacy of diclofenac in pain reduction after topography-guided transepithelial surface ablation","volume":"239","author":"Jost","year":"2022","journal-title":"Klin. Monbl Augenheilkd"},{"key":"B16","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.jtos.2024.08.001","article-title":"Preservatives and ocular surface disease: a review","volume":"34","author":"Kahook","year":"2024","journal-title":"Ocul. Surf."},{"key":"B17","doi-asserted-by":"publisher","first-page":"158","DOI":"10.22336\/rjo.2025.26","article-title":"Transepithelial photorefractive keratectomy - an analysis of the solutions offered by the industry nowadays","volume":"69","author":"Margarit","year":"2025","journal-title":"Rom. J. Ophthalmol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"25327","DOI":"10.1038\/s41598-025-10445-9","article-title":"TransPRK in the treatment of low to moderate and high myopia: a comparative study of the clinical outcomes","volume":"15","author":"Shi","year":"2025","journal-title":"Sci. Rep."},{"key":"B19","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1111\/aos.17500","article-title":"Preservatives in artificial tears: assessing impact on dry eye symptoms: findings from 67 951 questionnaire responses-project FOREVER","volume":"103","author":"Sj\u00f6","year":"2025","journal-title":"Acta Ophthalmol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1016\/j.ophtha.2022.07.028","article-title":"Management of pain after photorefractive keratectomy: a report by the American academy of ophthalmology","volume":"130","author":"Steigleman","year":"2023","journal-title":"Ophthalmology"},{"key":"B21","doi-asserted-by":"publisher","first-page":"3321","DOI":"10.1177\/11206721221082301","article-title":"Bandage contact lens soaked in 0.1% diclofenac to relieve early postoperative pain and foreign body sensation after transepithelial photorefractive keratectomy","volume":"32","author":"Wang","year":"2022","journal-title":"Eur. J. Ophthalmol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"16","DOI":"10.3390\/vision8010016","article-title":"Transepithelial photorefractive keratectomy-review","volume":"8","author":"Way","year":"2024","journal-title":"Vis. (Basel)"},{"key":"B23","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1080\/08164622.2023.2197107","article-title":"Investigation of corneal epithelial thickness and irregularity by optical coherence tomography after transepithelial photorefractive keratectomy","volume":"107","author":"Weng","year":"2024","journal-title":"Clin. Exp. Optom."},{"key":"B24","doi-asserted-by":"publisher","first-page":"1517403","DOI":"10.3389\/fmed.2025.1517403","article-title":"Management of delayed corneal epithelial healing after refractive surgery: five case reports","volume":"12","author":"Yan","year":"2025","journal-title":"Front. Med. (Lausanne)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1007\/s10792-025-03626-y","article-title":"Dry eye after photorefractive keratectomy (PRK) and transepithelial photorefractive keratectomy (T-PRK): a comparative clinical study","volume":"45","author":"Zarei-Ghanavati","year":"2025","journal-title":"Int. Ophthalmol."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1781133\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T05:45:40Z","timestamp":1776231940000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2026.1781133\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,15]]},"references-count":25,"alternative-id":["10.3389\/fphar.2026.1781133"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2026.1781133","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,15]]},"article-number":"1781133"}}