Epidemiology of Persistent Postsurgical Pain Manifesting as Dry Eye-Like Symptoms After Cataract Surgery. Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Sajnani, Ravin; Raia, Sophia; Gibbons, Allister; Chang, Victoria; Karp, Carol L.; Sarantopoulos, Constantine D.; Levitt, Roy C.; Galor, Anat
• Is Part Of: Cornea. Volume 37:Issue 12(2018)
• Publication Date: 2018-12
• Subjects: cataract surgery -- dry eye symptoms -- persistent postsurgical pain -- epidemiology; Cornea -- Periodicals; Cornea -- Periodicals; Cornée -- Périodiques; 617.719
• DOI: 10.1097/ICO.0000000000001741
• Languages: English
• ISSNs: 0277-3740

Abstract

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. Abstract : Supplemental Digital Content is Available in the Text.