June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Epidemiology and Risk Factors for Refractive Surgery Associated Ocular Pain
Author Affiliations & Notes
  • Jason Betz
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
    Surgical Services, VA Miami Healthcare System, Miami, Florida, United States
  • Sue Aicher
    Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, Oregon, United States
  • Hannah Behrens
    Department of Chemical Physiology & Biochemistry, Oregon Health & Science University, Portland, Oregon, United States
  • BROOKE M HARKNESS
    Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Richard Stutzman
    Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Winston Chamberlain
    Oregon Health & Science University Casey Eye Institute, Portland, Oregon, United States
  • Anat Galor
    University of Miami Health System Bascom Palmer Eye Institute, Miami, Florida, United States
    Surgical Services, VA Miami Healthcare System, Miami, Florida, United States
  • Footnotes
    Commercial Relationships   Jason Betz None; Sue Aicher None; Hannah Behrens None; BROOKE HARKNESS None; Richard Stutzman None; Winston Chamberlain None; Anat Galor None
  • Footnotes
    Support  NIH National Eye Institute R61EY032468 (Drs. Aicher & Galor)
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 4367 – A0304. doi:
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      Jason Betz, Sue Aicher, Hannah Behrens, BROOKE M HARKNESS, Richard Stutzman, Winston Chamberlain, Anat Galor; Epidemiology and Risk Factors for Refractive Surgery Associated Ocular Pain. Invest. Ophthalmol. Vis. Sci. 2022;63(7):4367 – A0304.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To examine the frequency and risk factors for ocular pain after laser assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK).

Methods : Prospective study of individuals undergoing refractive surgery. All individuals were seen prior to surgery and 3 months after surgery. Questionnaires regarding dry eye and ocular pain symptoms were completed at both time points. In addition, a comprehensive ocular surface assessment was performed at 3 months. The primary outcome measures were the frequency of ocular pain 3 months after surgery and risk factors for peristent pain. The latter were examined using multivariable forward stepwise logistic regression analyses.

Results : 58 individuals were enrolled into the study, with a mean age of 33±9 years (range 23 to 57); 65.5% (n=38) self identified as female, 74% as white, and 43% as Hispanic. The majory of individuals underwent bilateral (n=57) LASIK (n=52). Prior to surgery, 15.5% (n=9) of individuals indicated that they had any ocular pain (>0 rating of average pain intensity over a 1 week recall, range 0-10), with the majority reporting mild pain (n=7 with a score of 1). At 3 months, 33% (n=19) of individuals reported ocular pain (average intensity of pain over a 1 week recall >0), 10 with a score >1. This included 12 individuals (63%) who developed new ocular pain after surgery. The two factors that significantly predicted ocular pain after surgery (score>0) were ocular pain (odds ratio (OR)=3.15, 95% confidence interval (CI) 1.28-7.71, p = 0.01) and dry eye symptoms (Ocular Surface Disease Index, OR=1.12, 95% CI 1.0-1.26, p=0.05) before surgery. Pre-operative contact lens use (OR=0.16, 95% CI 0.03-0.90, p = 0.04) was protective against post-operative pain. When considering factors associated with pain intensity >1 at 3 months, pre-operative pain scores again predicted post-operative pain (OR=2.90, 95% CI 1.37-6.14, p=0.005) along with higher depression scores pre-surgery (Patient Health Questionniare-9, OR=1.38, 95% CI 1.08-1.75, p=0.01). Importantly, the majority (94%) of individuals were completely (70%) or somewhat (24%) satisfied with the results of their surgery.

Conclusions : A significant proportion of individuals report mild or greater post-operative pain 3 months after refractive surgery, with ocular pain prior to surgery being the most significant predictor for pain after surgery.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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