AccScience Publishing / GTM / Volume 3 / Issue 2 / DOI: 10.36922/gtm.1770
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BRIEF REPORT

Assessment of ocular neuropathic pain following vitreoretinal surgery using 23-gauge sclerotomy

Hanieh Niktinat1 Fardin Yousefshahi1 Kaveh Fadakar1 Golshan Latifi1 Farid Kalantaritarari2 Marjan Imani Fooladi1 Parichehr Ghahari1 Mehrdad Goudarzi3 Nazanin Ebrahimiadib4*
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1 Department of Ophthalmology, Tehran University of Medical Sciences, Tehran, Iran
2 Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran
3 Department of Anesthesiology, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
4 Department of Ophthalmology, University of Florida, College of Medicine, Gainesville, FL, United States of America
Global Translational Medicine 2024, 3(2), 1770 https://doi.org/10.36922/gtm.1770
Submitted: 6 September 2023 | Accepted: 25 January 2024 | Published: 23 April 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Ocular neuropathic pain refers to persistent post-operative perception of ocular discomfort in the absence of painful stimuli. This study investigates persistent ocular pain following 23-gauge pars plana vitreoretinal surgery. In the present study, patients who underwent either 23-gauge vitrectomy or silicone oil removal, under local or general anesthesia, were included. The symptoms of ocular neuropathic pain were evaluated using the brief pain inventory questionnaire before and 2 months after surgery. In addition, the impact of reported ocular symptoms on quality of life was assessed. We also evaluated the correlation between ocular pain and factors such as patient demographics and underlying systemic conditions. This study includes 75 eyes of 75 patients with an average age of 58.93 ± 12.05 years. Of the included patients, 31 (41.3%) were female. Among the participants, 67 (89.3%) underwent pars plana vitrectomy, and 8 (10.7%) experienced silicone oil removal surgery. Analysis using paired t-test or Wilcoxon signed-rank test, based on data normality, indicated no significant change in eye pain scores 2 months after surgery. However, the percentage of patients using analgesics increased from 4% before surgery to 17.3% 2 months after surgery (P = 0.021). Furthermore, based on a linear regression model, patients who reported increased analgesic usage 2 months after surgery also scored worse on the quality-of-life questionnaire (P < 0.05). We also found that those who reported ocular pain, facial pain, and photophobia before surgery had a higher likelihood of using analgesics after surgery (P = 0.03, 0.003, and 0.001, respectively). In addition, regression analysis revealed that patients with migraine headaches and lower levels of education were more likely to develop eye symptoms postoperatively (P = 0.017 and 0.044, respectively). In conclusion, surgeries involving 23-gauge scleral incisions do not significantly induce ocular neuropathic pain within 2 months after surgery. However, there is an observed increase in the use of analgesics following surgery.

Keywords
Chronic pain
Post-operative pain
Eye pain
Quality of life
Surveys and questionnaires
Vitrectomy
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
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Global Translational Medicine, Electronic ISSN: 2811-0021 Print ISSN: 3060-8600, Published by AccScience Publishing