The effect of topical administration of indomethacin on symptoms in corneal scars and edema

Combined indomethacin/gentamicin eyedrops to reduce pain after traumatic corneal abrasion

PURPOSE

To evaluate the analgesic action of combined indomethacin 0.1%/gentamicin eyedrops in traumatic corneal abrasion.

METHODS

We evaluated 123 patients presenting traumatic corneal abrasion in a multicentre, randomised, double-masked study comparing two parallel treatment groups: indomethacin/gentamicin (group 1) or gentamicin alone (group 2). Study treatments were administered four times daily for 5-6 days. Pain (visual analogue scale), associated symptoms and safety were assessed.

RESULTS

Starting from a comparable level, pain was reduced by 30% in group 1 and 15% in group 2, one hour after the first instillation, and by 59% and 42% respectively after the second. The global difference in pain relief from day 0 to day 4/5 was significantly better in group 1 (p = 0.015). Associated ophthalmic symptoms showed a greater decrease in group 1 after the first instillation (p = 0.007). Both treatments were well tolerated.

CONCLUSIONS

Combined indomethacin/gentamicin eyedrops were effective and well tolerated in reducing the pain and discomfort associated with traumatic corneal abrasion.

Topical indomethacin solution versus dexamethasone solution for treatment of inflamed pterygium and pinguecula: a prospective randomized clinical study

PURPOSE

To compare the effect of topical indomethacin 0.1% solution with the effect of topical dexamethasone 0.1% phosphate solution on signs and symptoms of inflamed pterygium and pinguecula.

METHODS

Of 50 consecutive patients who had inflamed pterygia (n = 17) or pingueculae (n = 33), met the study criteria, and signed an informed consent, one eye of each patient was evaluated in a comparative, prospective, randomized, double-masked, controlled study. Objective signs (conjunctival congestion, redness and edema, and staining of cornea) and subjective complaints (photophobia, pain, foreign-body sensation, discomfort, and tearing) were evaluated and scored. We also evaluated "total signs," "total symptoms," and "total score." Group 1 (n = 25) received topical indomethacin 0.1% solution, and group 2 (n = 25) received a topical dexamethasone phosphate 0.1% solution six times daily for 3 days, then four times daily over the following 11 days. Patients were examined before treatment, on days 3, 7, and 14 after the treatment was initiated, and 2 and 4 weeks after the treatment was discontinued.

RESULTS

In both groups, the scores for "total signs," "total symptoms," and "total score" were significantly lower (P = .001) by day 14. There were no differences between groups 1 and 2 for "total signs," "total symptoms," and "total score" at days 3, 7, and 14 (P = .07 to P = .88). After treatment was discontinued, the dexamethasone-treated group experienced a significantly greater recurrence of "total signs" (P = .023 at day 30, P = .02 at day 45), but there was no statistically significant difference in "total symptoms" and "total score." Patients in group 2 reported more stinging after drops were administered than patients in group 1 (P = .002).

CONCLUSIONS

This study indicates that topical indomethacin 0.1% solution is as effective as topical dexamethasone phosphate 0.1% solution for the treatment of inflamed pterygium and pinguecula and, therefore, is suggested as an effective treatment for these conditions.