Abstract
Purpose :
Neuropathic corneal pain (NCP) is caused by a lesion or disease of the somatosensory system. This study aims to understand postoperative neuropathic corneal pain in patients after cataract surgery based on Ocular Pain Assessment Survey (OPAS) and ophthalmologic evaluation.
Methods :
This prospective ongoing study included 46 patients undergoing cataract surgery. The OPAS was applied, followed by the Schirmer test, hypertonic saline 5% (HS) test, and proparacaine (PPC) test, which was used to differentiate between peripheral or central NCP. The follow-up was 1, 3, and 6 months after their surgery. Generalized Estimating Equations were used to analyze the patient's evolution and p< 0.05 was considered statistically significant.
Results :
In this study, 63% (29/46) were female and the mean age was 69.1 ±6.9 yo. In preoperative evaluation, pain intensity was 1.0±2.5, eye pain intensity in 24 hours was 0.4±1.3, eye pain intensity in 2 weeks was 0.8±2.1, non-eye pain was 1.6±2.8, quality of life was 2.8±3.4, aggravating factors were 11.6±29.5%, associated factors were 14.5±25.6% and symptom relief 40.7±39.8%. On six months follow-up, pain intensity decreased to 0.3±1.2, eye pain intensity in 24 hours was 0.8±1.9, eye pain intensity in 2 weeks was 0.7±1.6, non-eye pain was 0.9±1.9, quality of life was 0.4±1.3, aggravating factors were 13.1±22.5%, associated factors were 15.7±24.7% and symptom relief 63±41.8%(Table 1).
The Schirmer test was 15.9±10.2mm in the right eye and 15.5±9.1mm in the left eye in preoperative exam. After 6 months, it went to 20.5±10.3mm (p=0.0715) and 19.8±10.3mm (p=0.0253), respectively. Only 2 patients reported pain during preoperative HS test, and both had total improvement in pain after PPC test. After 1 month, 26.1%(12/46) felt discomfort after a HS test. PPC test showed that 91.7%(11/12) had peripheral NCP and 8.3%(1/12) had central NCP. In the third month, 9.1%(4/40) had pain after the HS test and from the PPC test, all of them had peripheral NCP 100%(4/4). On the last exam, only 2.3%(1/44) had pain after a HS test, and resolved after PPC test (Table 2).
Conclusions :
Cataract surgery is one of the causes of NCP, however, in this study, the patients did not develop chronic peripheral or central pain. More studies should be encouraged to understand the risk factors and mechanisms between them.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.