Ocular pain and discomfort after advanced surface ablation: an ignored complaint

Abstract

PurposeLaser vision correction is one of the most commonly performed elective surgical procedures in ophthalmology. Generally, discomfort besides pain (photophobia, burning sensation, tearing, and foreign body sensation) after these procedures is not taken into consideration in the clinical practice. The objective is to provide data on these symptoms and their relevance after advanced surface ablation (ASA).MethodsSingle-center survey study based on a structured questionnaire relative to the patients’ perceived symptoms after ASA. Inclusion criteria were: ≥18 years old, no ocular disease, with myopia (0.75 to 9 D) or hyperopia (0.25 to 5 D) with or without astigmatism, receiving ASA on at least one eye. All procedures were performed by the same surgeon. A descriptive analysis was performed.ResultsSeventy-three consecutive patients (34 men and 39 women) were included in the study. The median (range) of age was 33 (19–64) years. Sixty-nine patients had surgery done on both eyes. Postoperative pain was the most frequent comorbidity (97% [95% confidence interval {CI}: 90–100]) with a median (range) of intensity (verbal numerical rating scale) score of 7 (2–10). Photophobia: 85% (95% CI: 75–92); burning sensation: 62% (95% CI: 50–73); tearing: 59% (95% CI: 47–70); and foreign body sensation: 48% (95% CI: 36–60) were also prevalent postoperative symptoms. Pain during ASA was reported for 44% (95% CI: 32–56) of patients.ConclusionComorbidities such as pain, photophobia, burning sensation, tearing, and foreign body sensation are prevalent after ASA procedure. Postoperative pain should be taken into consideration due to its prevalence and intensity. A new and more efficient postoperative analgesic protocol should be established.

Nepafenac Ophthalmic Suspension 0.3% for the Management of Ocular Pain After Photorefractive Keratectomy

“…Postoperative discomfort or pain is still considered a bothersome side effect of PRK and a deterrent Nepafenac Ophthalmic Solution 0.3% for PRK/Kontadakis et al for performing the procedure to numerous patients. [5][6][7] Some patients who are not ideal candidates for LASIK postpone PRK due to the fear of postoperative pain. Methods to relieve postoperative pain include different techniques of epithelium removal, such as LASEK, epi-LASIK, phototherapeutic keratectomy, use of chilled balance salt solution postoperatively, bandage contact lenses and topical medication, and NSAIDs.…”

Pain perception description after advanced surface ablation

“…Based on a previous questionnaire developed by Sobas et al,10 the presence and intensity of the following ocular symptoms were recorded: photophobia, burning sensation, tearing, foreign body, itching, and headache. The intensity of each item was rated on a Likert scale of 4 points (range 0–3, where 0 corresponded to no symptom and 3 to the worst imaginable symptom) 11.…”

“…Sample size was based on our previously published study in which 97% had postoperative pain 10 Subsequent to that study, clinical records suggested that 99% of patients had postoperative pain after ASA (unpublished data). Thus, we assumed that 98% of the participants would have ocular pain.…”

Eclectic Ocular Comorbidities and Systemic Diseases with Eye Involvement: A Review

“…Other eye comorbidities have been described in cases of advanced surface ablation during laser refractive surgery that manifested themselves in the postoperative period with signs and symptoms such as burning/foreign body sensation, tearing, pain, and photophobia. As a consequence of this, instauration of a precise analgesic protocol has been recently suggested for patients subjected to these procedures [ 11 ].…”