屈光手術後的眼痛：頻率和風險因素的中期分析

Ophthalmology Volume 130, Number 7, July 2023

中文摘要

本研究旨在檢視LASIK and PRK後眼痛的頻率和風險因素。該研究作為一項前瞻性研究，在兩個不同的中心進行。

研究納入了109名接受屈光手術的患者，其中87％接受LASIK手術，PRK。參與者在手術後3個月和6個月接受眼表健康的臨床檢查。持續性眼痛被定義為手術後3個月和6個月的數字評分量表（Numeric Rating Scale, NRS）得分均為3分或更高。將有持續性疼痛的患者與在這兩個時間點上NRS得分低於3分的對照參與者進行比較。

結果顯示，手術後眼痛的頻率增加。手術前，有7％的患者報告眼痛，NRS得分為3分或更高。然而，在手術後3個月，眼痛的頻率增加到23％，在6個月時達到24％。在參與者中，有11％在手術後3個月和6個月都報告有持續性眼痛。

該研究確定了屈光手術後持續性眼痛的風險因素。預術期疼痛、術後急性疼痛、抑鬱症狀以及手術前口服抗過敏藥物的使用與持續性疼痛風險增加有關。

總的來說，該研究發現許多人在屈光手術後會出現持續性眼痛。研究結果表明，神經病理機制可能導致這種疼痛。該研究強調了確定風險因素並制定預防和治療策略以應對屈光手術後持續性眼痛的重要性。

值得注意的是，這是一項正在進行中的研究的中期分析，其結果應謹慎解讀。需要進一步的研究來驗證這些發現並探索屈光手術後持續性眼痛的潛在機制。

English Abstract

Title: Ocular Pain after Refractive Surgery
Interim Analysis of Frequency and Risk Factors

The purpose of the study was to examine the frequency and risk factors for ocular pain after laser-assisted in situ keratomileusis (LASIK), and photorefractive keratectomy (PRK) . The study was conducted as a prospective study involving individuals undergoing refractive surgery at two different centers.

A total of 109 individuals undergoing refractive surgery, with 87% undergoing LASIK and 13% undergoing PRK, were included in the study. The participants underwent a clinical examination focused on ocular surface health at 3 and 6 months after surgery. Persistent ocular pain was defined as a Numeric Rating Scale (NRS) score of 3 or more at both 3 and 6 months after surgery. A group of patients with persistent pain was compared to control participants who had NRS scores of less than 3 at both time points.

The results showed that the frequency of ocular pain increased after surgery. Before surgery, 7% of patients reported ocular pain with an NRS score of 3 or more. However, at 3 months after surgery, the frequency of ocular pain increased to 23%, and at 6 months, it was 24%. Among the participants, 11% reported persistent ocular pain at both 3 and 6 months after surgery.

The study identified risk factors for persistent ocular pain after refractive surgery. Factors such as preoperative pain, acute postoperative pain (Day 1) , depression symptoms, and the use of oral antiallergy medication before surgery were associated with an increased risk of persistent pain.

Overall, the study found that a significant proportion of individuals experience persistent ocular pain after refractive surgery. The findings suggest that neuropathic mechanisms may contribute to this pain. The study highlights the importance of identifying risk factors and developing preventive and treatment strategies to address persistent ocular pain after refractive surgery.

It is worth noting that this is an interim analysis of an ongoing study, and the results should be interpreted with caution. Further research is needed to validate the findings and investigate potential mechanisms underlying persistent ocular pain after refractive surgery.