Ravin Sajnani1, Sophia Raia1, Allister Gibbons1, Victoria Chang1, Carol L Karp1, Constantine D Sarantopoulos1,2, Roy C Levitt1,2,3,4, Anat Galor1,5. 1. Bascom Palmer Eye Institute, University of Miami, Miller School of Medicine, Miami, FL. 2. Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami, Miller School of Medicine, Miami, FL. 3. John P. Hussman Institute for Human Genomics, University of Miami, Miller School of Medicine, Miami, FL. 4. John T Macdonald Foundation Department of Human Genetics, University of Miami, Miller School of Medicine, Miami, FL. 5. Department of Ophthalmology, Miami Veterans Affairs Medical Center, Miami, FL.
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.
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: Jerry P Kalangara; Anat Galor; Roy C Levitt; Derek B Covington; Katherine T McManus; Constantine D Sarantopoulos; Elizabeth R Felix Journal: Eye Contact Lens Date: 2017-05 Impact factor: 2.018
Authors: Malvina Eydelman; Gene Hilmantel; Michelle E Tarver; Elizabeth M Hofmeister; Jeanine May; Keri Hammel; Ron D Hays; Frederick Ferris Journal: JAMA Ophthalmol Date: 2017-01-01 Impact factor: 7.389
Authors: Alexandra E Levitt; Anat Galor; Aneesa R Chowdhury; Elizabeth R Felix; Constantinos D Sarantopoulos; Gerald Y Zhuang; Dennis Patin; William Maixner; Shad B Smith; Eden R Martin; Roy C Levitt Journal: Mol Pain Date: 2017 Jan-Dec Impact factor: 3.395
Authors: Anat Galor; Roy C Levitt; Katherine T McManus; Jerry P Kalangara; Benjamin E Seiden; Jasmine J Park; Derek B Covington; Constantine D Sarantopoulos; Elizabeth R Felix Journal: JAMA Ophthalmol Date: 2016-11-01 Impact factor: 7.389