Neuropathic Corneal Pain in Post-Cataract Surgery Patients

Abstract

Purpose : Neuropathic Corneal Pain (NCP) is a chronic pain caused by a lesion or dysfunction of the somatosensory nervous system. Long term injury to the peripheral corneal sensory nerves leads to the development of ectopic activity and abnormal excitability of peripheral nerve terminals, causing neuropathic pain. Cataract surgery is the most common procedure performed by ophthalmic surgeons worldwide. Modern phacoemulsification cataract surgery typically involves clear-corneal incisions. The placement of incisions in clear-corneal procedures can damage corneal nerves. The aim of this study is to describe a case series of patients that developed neuropathic corneal pain.

Methods : Retrospective, cross sectional study from 175 patients with neuropathic corneal pain conducted at New England Eye Center/ Tufts Medical Center over the past year. All patients that had undergone cataract surgery were included in the study. The visual analogue scale (VAS) (0-10) was used to rate the pain levels.

Results : Of the 175 NCP patients enrolled, 128 (73%) had undergone ocular surgery; 25 (20%) had undergone cataract surgery. Of those who had cataract surgery, 17 (68%) were female and the average age was 74.04 ± 9.72 years. Of the 25 patients that had cataract surgery, 19 (76%) had cataract surgery alone, while 4 (16%) had cataract surgery combined with refractive surgery; 17 patients (68%) reported an average pain level of 4.8±2.2; the remaining 8 (32%) of patients complained of symptoms of photoallodynia and discomfort.

Conclusions : Cataract surgery could be a risk factor for neuropathic corneal pain. Future prospective and longitudinal studies are warranted and should be encouraged in order to further establish the relationship between NCP and cataract surgery.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.