Evaluation of the Effect of Topical Vitamin A Eye Ointment on Pain Reduction and Accelerated Healing of Corneal Defect After Photorefractive Keratectomy: A Prospective Randomized Controlled Study.

BACKGROUND AND AIMS: Photorefractive keratectomy (PRK) is commonly used for refractive errors but is associated with postoperative pain and delayed epithelial healing. Vitamin A has been shown to support epithelial regeneration and corneal wound healing. This study aimed to evaluate the effect of topical vitamin A (retinol palmitate) on postoperative pain and corneal epithelial healing after PRK.

METHODS

A double-blind, randomized controlled trial was conducted on 56 eyes of 28 myopic patients undergoing PRK at Imam Khomeini Hospital, Ahvaz, Iran. Participants were assigned to a vitamin A ointment group (250 IU/g in a petrolatum-based ointment) or a control group. The primary outcome was corneal epithelial healing, and the secondary outcome was postoperative pain, measured using the visual analog scale (VAS).

RESULTS

Corneal healing was significantly faster in the vitamin A group, with smaller epithelial defects at 24 h (19.32 ± 6.21 mm² vs. 26 ± 8.28 mm², p = 0.023), 2 days (10.64 ± 3.45 mm² vs. 16.17 ± 6.71 mm², p = 0.01), and 3 days (2.96 ± 2.47 mm² vs. 6.17 ± 3.99 mm², p = 0.016). However, by Day 4, the difference was no longer significant (p = 0.16). Postoperative pain, measured on the VAS, showed no significant differences between the two groups at any time point: 12 h (p = 0.26), 24 h (p = 0.08), 2 days (p = 0.17), and 3 days (p = 0.37). Both groups demonstrated a general decrease in pain over time, but no significant interaction effect was observed between group and time (F (3, 162) = 0.26, p = 0.36).

CONCLUSION

Topical vitamin A accelerated corneal epithelial healing after PRK, especially in the first 3 days post-surgery. However, it did not significantly reduce postoperative pain. These results suggest vitamin A aids in wound healing, but its role in pain management after PRK remains unclear. Larger studies with longer follow-up are needed to explore its effects further.