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

Abstract

Objective To investigate the presence of persistent ocular pain after 23-gauge pars plana vitreoretinal surgery Method This is a prospective study including patients who underwent 23-gauge vitrectomy or silicone removal with local or general anesthesia. We evaluated the symptoms of ocular neuropathic pain before and two months after surgery using the Brief Pain Inventory (BPI) questionnaire, and the impact of reported ocular symptoms on quality of life. Correlation between ocular pain and factors such as patient demographics and underlying conditions were also assessed. Result 75 patients with a mean age of 58.93 ± 12.05 years were evaluated. 44 (58.7%) were males. 67 (89.3%) patients underwent vitrectomy and eight had silicone removal surgery, all using 23-gauge instruments. there was an increasing trend in eye pain scores two months after surgery which did not reach a statistical significance. However, the analgesic consumption increased from 4% before surgery to 17.3% two months after surgery. Patients who reported increased analgesic usage two months after surgery, scored worse in items of the quality-of-life questionnaire. In addition, patients who reported ocular and facial pain and photophobia before surgery had higher chances of analgesic consumption after surgery (p-value: 0.03, 0.003, and 0.001, respectively). Those who reported migraine headaches had higher chances of reporting eye symptoms, postoperatively (p-value: 0.041). Conclusion Surgeries involving 23-gauge incisions may not induce ocular neuropathic pain. However, increased use of analgesics after surgery was observed.