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Purpose: To evaluate the analgesic effect of topical sodium diclofenac 0.1% before retinal laser photocoagulationfor diabetic retinopathy. Methods: Diabetic patients who were candidates for peripheral laser photocoagulation were included in a randomized,placebo-controlled, intraindividual, two-period, and crossover clinical trial. At the first session andbased on randomization, one eye received topical sodium diclofenac 0.1% and the other eye received an artificialtear drop (as placebo) three times before laser treatment. At the second session, eyes were given thealternate drug. Patients scored their pain using visual analogue scale (max, 10 cm) at both sessions. Patientsand the surgeon were blinded to the drops given. Difference of pain level was the main outcome measure. Results: A total of 200 eyes of 100 patients were enrolled. Both treatments were matched regarding the appliedlaser. Pain sensation based on visual analogue scale was 5.6 ± 3.0 in the treated group and 5.5 ± 3.0 in thecontrol group. The calculated treatment effect was 0.15 (95% confidence interval, –0.27 to 0.58; p = 0.486). The estimated period effect was 0.24 (p = 0.530) and the carryover effect was not significant (p = 0.283). Conclusions: Pretreatment with topical sodium diclofenac 0.1% does not have any analgesic effect during peripheralretinal laser photocoagulation in diabetic patients.

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