Analgesic Effect of Nepafenac vs Diclofenac Eye Drops on Pain Associated with Intravitreal Injections: A Comparative Study

Abstract

Objective: This research is aimed at the investigation of analgesic properties of nepafenac and diclofenac eye drops to intravitreal injections in terms of pain.

Methodology: This study was conducted in Ophthalmology department, Fauji Foundation Hospital Rawalpindi from 5th December 2025 to 5th March 2026. Sixty patients were equally divided into two groups by non-randomized sampling technique. Group A was treated with nepafenac eye drops and Group B was treated with diclofenac eye drops before the procedure. Pain associated with the intravitreal injection was measured on Visual Analog Scale (VAS) and the Short-Form McGill Pain Questionnaire (SF-MPQ). The data was analyzed by means of IBM SPSS version 23. Quantitative variables such as age and pain scores were presented in the form of mean and standard deviation whereas qualitative variables such as gender and comorbidities were presented in the form of frequency and percentages. The independent sample t-test was used to compare the pain levels between the two groups; the level of significance was considered as p < 0.05.

Results: The mean age of the participants was 60.45±10.17 years with 93.3% of them being females. The mean immediate VAS scores and late VAS scores of nepafenac and diclofenac were 2.47±1.57 and 1.90±0.96 and 0.87±0.82 and 0.47±0.63 respectively. The late SF-MPQ scores were 0.63±0.61 for nepafenac group, and 0.40±0.56 for diclofenac group, the mean immediate SF-MPQ scores were 1.87±0.82 in the case of nepafenac group and 1.57±0.72 in the case of diclofenac group. There was a slight reduction in the pain scores of the diclofenac group but there was no significant difference between the two groups (p > 0.05). Most of the patients only had a slight discomfort during the operation.

Conclusion: Finally, the differences between nepafenac and diclofenac eye drops in terms of their capacity to reduce the pain following intravitreal injection are statistically insignificant. Either of the drugs can be applied topically to provide analgesia to patients undergoing intravitreal injection therapy to enhance their comfort.