Abstract
Purpose :
Micropulse transscleral diode cyclophotocogulation (CPC) builds on the traditional transcleral diode laser by micropulsing the diode laser to the targeted tissue to further minimize post-procedural adverse events such as pain, inflammation, hypotony, vision loss, and phthisis. It has been reported that micropulse CPC is well tolerated by patients when performed in an outpatient surgical setting with intravenous sedation with and without a local nerve block as anesthesia. This study aims to characterize the ocular pain level of patients during and after the micropulse CPC in an outpatient clinc setting with a local nerve block as anesthesia.
Methods :
This is a prospective observational survey of patients who have undergone the micropulse CPC for uncontrolled intraocular pressure that failed medical and or surgical intervention. Wayne State University’s Institutional Review Board has approved the study for research purposes. The survey consists of patients’ self-reported ocular pain levels using the Wong-Baker FACES pain rating scale. We collated patients’ reported pain level before micropulse CPC, during the regional nerve block, during the laser procedure, the first 24-hours after the procedure, and day two to seven after the procedure.
Results :
Based on summative responses collected from five patients, the average reported ocular pain level before the procedure was 0 on the Wong-Baker FACES pain rating scale; 0 represents no hurt and 10 represents hurts worst. The average reported ocular pain level during the regional nerve block was 6 out of 10, 4 out of 10 during the laser procedure, and 7 out of 10 within the first 24-hours and 2 out of 10 during day two to seven after the procedure.
Conclusions :
In literature, it is reported that micropulse CPC is generally well tolerated by patients when performed in the outpatient surgical setting with sedation with and without a local nerve block as anesthesia. However, to our knowledge, no documentation of tolerance levels in the outpatient clinic setting without intravenous sedations have been reported. Nor are there published reports regarding patients' perceived pain level using a standardized and valid pain scale tool during the laser procedure. Thus, our study is the first to characterize self-reported ocular pain levels using a standardized pain scale. Our results show that patients have the most amount of pain within the first 24-hours.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.