RESUMEN
IMPORTANCE: Intravitreal injections (IVI) are often painful. BACKGROUND: To evaluate the analgesic effect of diclofenac in patients undergoing IVI. DESIGN: Single-centre, prospective, randomized, triple-arm, placebo-controlled, interventional study in the University Hospital of Patras. PARTICIPANTS: Seventy-four patients. METHODS: Group 1 (n = 25) received topical diclofenac 45 min before IVI, Group 2 (n = 25) received oral diclofenac 4 h before IVI and topical diclofenac while Group 3 (n = 24) received placebo before IVI. Using the short form of the McGill Pain Questionnaire (SF-MPQ), pain intensity was assessed with the visual analogue scale (VAS), the main component of the SF-MPQ and the Present Pain Intensity (PPI) scores immediately and 6 h post-IVI. MAIN OUTCOME MEASURES: The VAS pain score immediately post-IVI. RESULTS: Immediately post-IVI, patients in Group 2 reported significantly lower VAS pain scores compared to placebo while no statistically significant difference was found between patients that received topical diclofenac and placebo. Six hours post-IVI, patients in both treatment groups reported significant lower VAS pain scores compared to placebo. The scores of the main component of the SF-MPQ were significantly lower in patients of treatment groups compared to placebo at both time-points. Finally, while no statistically significant difference was found between the 3 Groups in PPI scores immediately post-IVI, 6 h later, patients of both treatment groups reported significantly lower PPI scores compared to placebo. CONCLUSIONS AND RELEVANCE: The combination of topical and oral diclofenac demonstrated better analgesic effect than topical diclofenac administration in patients undergoing IVI immediately and up to 6 h post-IVI.