Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery.

Abstract

PURPOSE:

To evaluate the epidemiology of persistent postsurgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery.

METHODS:

This single-center study included 119 individuals whose cataract surgeries were performed by a single surgeon at the Bascom Palmer Eye Institute and who agreed to participate in a phone survey 6 months after surgery. Patients were divided into 2 groups: the PPP group was defined as those with a Dry Eye Questionnaire-5 score ≥6 and without PPP as those with a Dry Eye Questionnaire-5 score <6 at 6 months after cataract surgery.

RESULTS:

Mean age of the study population was 73 ± 8.0 years; 55% (n = 66) were female. PPP was present in 34% (n = 41) of individuals 6 months after surgery. Factors associated with an increased risk of PPP were female sex [odds ratio (OR) = 2.68, 95% confidence interval (CI) = 1.20-6.00, P = 0.01], autoimmune disorder (OR = 13.2, CI = 1.53-114, P = 0.007), nonocular chronic pain disorder (OR = 4.29, CI = 1.01-18.1, P = 0.06), antihistamine use (OR = 6.22, CI = 2.17-17.8, P = 0.0003), antireflux medication use (OR = 2.42, CI = 1.04-5.66, P = 0.04), antidepressant use (OR = 3.17, CI = 1.31-7.68, P = 0.01), anxiolytic use (OR = 3.38, CI = 1.11-10.3, P = 0.03), and antiinsomnia medication use (OR = 5.28, CI = 0.98-28.5, P = 0.047). PPP patients also reported more frequent use of artificial tears (P < 0.0001), higher ocular pain levels (P < 0.0001), and greater neuropathic ocular pain symptoms, including burning (P = 0.001), wind sensitivity (P = 0.001), and light sensitivity (P < 0.0001).

CONCLUSIONS:

PPP in the form of persistent DE-like symptoms is present in approximately 34% of individuals 6 months after cataract surgery. The frequency of PPP after cataract surgery is comparable to that of other surgeries including laser refractive surgery, dental implants, and genitourinary procedures.

• Authors: Ravin Sajnani, Sophia Raia, Allister Gibbons, Victoria Chang, Carol L Karp, Constantine D Sarantopoulos, Roy C Levitt, Anat Galor
• Journal: Cornea (Cornea) Vol. 37 Issue 12 Pg. 1535-1541 (Dec 2018) ISSN: 1536-4798 [Electronic] United States
• PMID: 30211743 (Publication Type: Journal Article)

Topics

• Aged
• Diagnosis, Differential
• Dry Eye Syndromes (diagnosis, epidemiology, etiology)
• Female
• Florida (epidemiology)
• Follow-Up Studies
• Humans
• Male
• Pain Measurement
• Pain, Postoperative (complications, diagnosis, epidemiology)
• Phacoemulsification (adverse effects)
• Prognosis
• Retrospective Studies
• Surveys and Questionnaires
• Time Factors