IS IT POSSIBLE TO PREDICT ACUTE PAIN AFTER PHOTOREFRACTIVE KERATECTOMY?
Published 2025 - 29th ESCRS Winter Meeting
Reference: FP07.02 | Type: Free Paper | DOI: 10.82333/x3mh-qg71
Authors: Kübra Gül Ölke* 1 , Mehmet Cüneyt Özmen 2 , Berkay Ulaş 2 , Lütfi Raşid Alkan 2 , Betül Seher Uysal 2 , Kamil Bilgihan 2
1Ophthalmology,Gazi University,Ankara,Türkiye;Ophthalmology,Mersin City Training and Research Hospital,Mersin,Türkiye, 2Ophthalmology,Gazi University,Ankara,Türkiye
Purpose
To determine the predictability and severity of acute pain after photorefractive keratectomy (PRK). Secondary outcome was to measure the effect of anxiety on the development of acute pain after PRK.
Setting
A prospective observational study
Methods
Prospectively, 112 consecutive myopic patients who were scheduled for bilateral PRK were included in the study. The eye with the highest spherical equivalent (SEQ) was selected to included in the analysis. Uncorrected and best-corrected visual acuity, manifest and cycloplegic refraction, complete biomicroscopic examination, fluorescein staining and tear break-up times were recorded. Corneal topography (Pentacam, MS 39) and dynamic Scheimpflug analyser (Corvis ST) were performed in all patients. The Beck Anxiety Questionnaire was administered during the preoperative waiting period and the Turkish validated Ocular Pain Assessment Questionnaire (T-OPAS) was administered 24 and 48 hours after surgery. All surgical procedures were performed by a single surgeon using the NIDEK EC-5000 with wavefront-guided segmental ablation software (multipoint ablation).
Results
Seventy-eight (69.64%) of the patients were female and the mean age was 27.91±5.14 D years, mean SEQ (the highest SEQ of the eyes in each patient) was -3.84±1.74 D and mean K (Kmean) value was 43.7±1.2 D. Multipoint ablation was added in 60 eyes (53.6%). According to the OPAS questionnaire on first and second day, the mean value of the most severe pain in the last 24 hours were 6.3±3.1 and 6.4± 2.8 (pain score range 0- 10). Linear regression analysis showed, the effect of multipoint ablation, Corvis tomographic and biomechanical index (TBI) values, Kmean and thinnest epithelium values on pain was statistically significant (p=0.011; 0.02; 0.04; 0.02, respectively). On correlation analysis, TBI and Kmean had no effect on pain (p=0.3; 0.204). The thinnest epithelium showed a statistically significant weak correlation (p=0.019; r=-0.222). Pain was statistically significantly more severe in the multipoint ablation group (p=0.016). The Beck Anxiety Questionnaire was not significantly associated with pain (p=0.17).
Conclusion
In this study, preoperative anxiety had no effect on the prediction of acute pain after PRK and multimodal examination had no clinically significant predictive value. Pain was more severe in eyes that underwent multipoint ablation.