Preop evaluation can lessen risk for postop corneal neuropathic pain
KOLOA, Hawaii —Evaluation before ocular surgery may help lessen the risk for development of corneal neuropathic pain postsurgically, a speaker here said.
“A lot of times, patients are told they have dry eye for years and years after LASIK, and it's actually neuropathic pain,” Helen K. Wu, MD, said in a presentation at Hawaiian Eye 2023. “Unfortunately, for that small subset that have severe intractable pain, this can lead to depression, decreased quality of life and suicidal ideation.”
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Neuropathy can occur in conjunction with any ocular surgery that cuts the nerves, including LASIK and cataract surgery, and is also seen in patients with a variety of conditions including dry eye, trauma, infection and systemic etiologies, she said.
“There are no known definitive screening tests for corneal neuropathic pain,” Wu said. “To evaluate these candidates, obtain a thorough history, do a thorough assessment and do any adjunctive testing based on their symptoms and signs, manage their expectations, talk to them about the very rare but real risk of developing neuropathic pain after surgery, let them know pain isn't normal after surgery, and defer surgery if significant risk factors are present.”
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Wu HK. Preoperative LASIK considerations to potentially lessen the chance of postoperative neuropathic pain. Presented at: Hawaiian Eye 2023; Jan. 14-20, 2023; Koloa, Hawaii.
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