Preservative-free proxymetacaine found safe and effective for post-CXL pain relief

Short-term use of preservative-free proxymetacaine hydrochloride drops is a safe and effective way to control postoperative pain after epithelium-off corneal crosslinking (CXL) for keratoconus, without causing any delay in corneal healing or complications, according to a study.

The observational study included 223 eyes from 180 patients, most of whom were young males with mild to severe keratoconus. Following CXL using a standard riboflavin and UV-A light protocol, patients were prescribed proxymetacaine drops on an as-needed basis for the first 3 days post-surgery.

At follow-up visits within 1–2 weeks, none of the patients exhibited delayed corneal healing or complications such as epithelial defects or early stromal haze. All participants reported effective pain relief, especially in the first 48 hours, and none experienced pain beyond the 3-day treatment window.

Reference
Elghobaier MG, Levy I, Nanavaty MA. Ten Years’ Experience Using Proxymetacaine Hydrochloride 0.5% for Postoperative Pain Control in Epithelium-Off Corneal Crosslinking. J Clin Med. 2025;14(13):4692. doi: 10.3390/jcm14134692. PMID: 40649066; PMCID: PMC12250031.