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Perry Rosenthal, Leslie Wu; Laser Keratorefractive Procedures As A Risk Factor For Corneal Neuropathic Pain. Invest. Ophthalmol. Vis. Sci. 2012;53(14):4045.
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To identify and characterize the risk factors of corneal neuropathic pain following laser keratorefractive procedures (LKP).
This retrospective chart review case series identified 18 patients (17 LASIK, 1 PRK) with severe corneal neuropathic pain (CNP) following LKP as determined by a history of otherwise unexplained corneal pain for a minimum of 2 years and the persistence of symptoms during immersion of the corneas in a pool of oxygenated artificial tears (scleral lens).
Gender ratio was 14f/4m. 17 patients had undergone LASIK and 1 PRK. The maximum interval between surgery and the onset of CNP in the absence of autoimmune disease or a known noxious corneal trigger was 9 years. Risk factors included persistent, severe worsening pain following post operative corneal re-epithelialization (60%), autoimmune disorders (11%), keratitis and/or pre-existing dry eye-like symptoms (77%) and soft contact lens-intolerance (92%).
Female sex, autoimmune disease, post-treatment keratitis and preexisting dry eye-like symptoms and soft contact lens intolerance appear to increase the risk of CNP following LKP. The onset of CNP may occur up to 9 years postoperatively.
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