Purpose:
To evaluate the epidemiology of persistent post-surgical pain (PPP) manifesting as dry eye (DE)-like symptoms 6 months after surgery.
Methods:
The single-center study population 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 six months after surgery. Patients were divided into two groups: PPP group was defined as those with a Dry Eye Questionnaire-5 (DEQ5) score≥6 and without PPP (WoPPP) as those with DEQ5 score<6 at six months after cataract surgery.
Results:
The 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 six months after surgery. Factors associated with an increased risk of PPP were female gender (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), non-ocular 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), anti-reflux 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 anti-insomnia medication use (OR=5.28,CI=0.98–28.5,p=0.047). PPP patients also reported more frequent artificial tears use (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 dry eye-like symptoms is present in approximately 34% of individuals six months after cataract surgery. The frequency of PPP after cataract surgery is comparable with that of other surgeries including laser refractive surgery, dental implants, and genitourinary procedures.
