Abstract
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.