Preoperative risk factors may help predict persistent eye pain after refractive surgery
Click Here to Manage Email Alerts
CHICAGO — A number of preoperative and perioperative variables may predict ocular pain following refractive surgery, according to a speaker here.
A better understanding of these variables can help improve patient counseling and influence treatment algorithms, according to Jason Betz, who was awarded the Troutman Prize at Refractive Surgery Subspecialty Day at the American Academy of Ophthalmology meeting.
Approximately 800,000 refractive procedures, including LASIK and PRK, are performed each year, Betz said, with most patients reporting positive visual outcomes and mild ocular symptoms during their surgical recovery window. However, some patients report persistent ocular symptoms including burning, discomfort, dryness and photophobia, which can last 6 months or longer after surgery.
“The question I wanted to answer with this project was: Who is experiencing these symptoms, and why?” Betz said. “We currently don’t have great data on predictors and risk factors on which patients are more likely to develop persistent ocular symptoms after surgery.”
To address these questions, Betz and colleagues conducted a prospective study of 109 patients who underwent LASIK or PRK at two sites and received ocular symptom questionnaires before and 1 day after surgery, as well as 3 months and 6 months after surgery. Persistent eye pain was defined as a numeric rating scale score of 3 or greater at both 3 months and 6 months. Patients with persistent pain were compared with patients with a score lower than 3 at both time points.
Approximately 7% of patients reported eye pain before their surgery, while 72% reported pain 1 day after their procedure. Among patients who reported persistent eye pain, the most common descriptions were soreness, grittiness, burning and pressure, which increased with exposure to light and wind, Betz said.
Betz said that risk factors for persistent pain included ocular pain before surgery, intensity of pain 1 day after surgery, use of oral anti-allergy medication and preoperative depression symptoms. More than 90% of patients indicated that they were completely or somewhat satisfied with their vision at both 3 months and 6 months after surgery.
Betz and colleagues are currently working on a new analysis of tear protein biomarkers for eye pain and hope to develop diagnostic and prognostic models for different pain phenotypes and therapeutic targets.
“We’re happy to report that since this publication that we are presenting, our sample size has grown to 280 with complete 6-month follow-up data, and we continue to actively recruit at both sites,” he said.
Reference:
- Betz J, et al. Ophthalmology. 2023;doi:10.1016/j.ophtha.2023.02.016.
Collapse
Betz J, et al. Ocular pain after refractive surgery: Interim analysis of frequency and risk factors. Presented at: American Academy of Ophthalmology meeting; Oct. 18-21, 2024; Chicago.
Read more about
Click Here to Manage Email Alerts