Combined Local and Systemic Diclofenac Administration versus Systemic Diclofenac Administration Only for Pain Control in Trans-Scleral Cyclo-Photocoagulation: A Randomized Controlled Trial

Elashri, Mohammed; Abdelnasser, Mohamed; Eissa, Ahmed; El Gabbar, Abdel Ghany; Messeha, Medhat; Ibrahim, Mohamed

doi:10.21608/ejomos.2025.326772.1151

Combined Local and Systemic Diclofenac Administration versus Systemic Diclofenac Administration Only for Pain Control in Trans-Scleral Cyclo-Photocoagulation: A Randomized Controlled Trial

Document Type : Original Articles

Authors

¹ Departments of ophthalmology, Faculty of Medicine, Kafrelsheikh University, Egypt

² Faculty of Medicine, Kafrelsheikh University

³ Assistant lecturer, Department of Ophthalmology, General Organization for Teaching Hospitals and Institutes, Cairo

⁴ Lecturer of Ophthalmology, Faculty of Medicine ,Al-Azhar university, Cairo , Egypt

⁵ Department of Anesthesia, surgical intensive care and Pain Management. Mansoura University Hospital, Mansoura 35516, Egypt

⁶ faculty of medicine, Kafrelshiekh university hospital

10.21608/ejomos.2025.326772.1151

Abstract

Aim: This research aimed to assess the impact of topical diclofenac Na versus systemic and topical diclofenac Na in pain control at or after trans-scleral diode application
Patients and Method: After institutional board (IRB) review was gained with approval code (MKSU 26-5-21), An investigation involving 37 glaucoma patients whether primary or secondary was carried out in a randomized controlled design. The patients were classified into two groups, group A: individuals undergoing diode application with applying local and systemic diclofenac eye drops. Group B: patients who underwent diode application with applying systemic diclofenac only.
This prospective interventional study was conducted in the period between Jun. 2021 and Dec. 2021 in the ophthalmology department, Kafrelshiekh University Hospital, Kafrelshiekh University, Egypt.
Results: Group A (mean age 54.83±11.79 years) showed significant VAS score reductions at 1 day, 1 week, and 1 month (p<0.001). Both groups exhibited significant VAS score improvements compared to pre-operative levels on 1st-day post-op (p<0.001). The mean 1st day visual acuity differed significantly between groups (p<0.001). Group two demonstrated a more substantial intraocular pressure reduction at 3 months (p<0.01).
Conclusion: Combined local and systemic diclofenac administration was associated with more pain control and should be used frequently in routine practice.

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