AIM: To investigate the effects of a cold patch on postoperative pain and other relevant reactions to transepithelial photorefractive keratectomy.

METHODS: In this prospective, randomized controlled study, forty patients(80 eyes)scheduled to undergo transepithelial photorefractive keratectomy for myopia or myopic astigmatism were randomly and equally divided to be treated with iced balanced salt solution during the surgery(washing group, 20 cases, 40 eyes)or to wear a postoperative cold compress for 24h(cold compress group, 20 cases, 40 eyes). The main outcomes were visual analogue pain score 8, 16, 24h after surgery, postoperative eyelid edema, conjunctival hyperemia, epithelial healing time, Haze, and postoperative best-corrected visual acuity.

RESULTS: Demographic data and the pain scores during surgery were similar between the two groups. The mean postoperative pain scores of patients in the cold compress group at 8, 16, and 24h were significantly lower than that of the washing group. Scores for postoperative eyelid edema and conjunctival hyperemia in the cold compress group were also lower than in the washing group. Patients in the cold compress group applied fewer painkillers. The epithelium healing time, Haze, and early recovery of visual acuity were similar between the two groups.

CONCLUSION: Wearing a cold eye shield after transepithelial photorefractive keratectomy can effectively relieve pain and inflammation and reduce the consumption of painkillers.