Iglesias Eugenia, Sajnani Ravin, Levitt Roy C, Sarantopoulos Constantine D, Galor Anat
Miami Veterans Affairs Medical Center, Miami, FL.
University of Miami Miller School of Medicine, Miami, FL.
Cornea. 2018 Jul;37(7):893-898. doi: 10.1097/ICO.0000000000001491.
To evaluate the frequency and risk factors for persistent postsurgical pain (PPP) after cataract surgery, defined as mild or greater dry eye (DE)-like symptoms 6 months after surgery.
This single-center study included 86 individuals who underwent cataract surgery between June and October 2016 and had DE symptom information available 6 months after surgery. Patients were divided into 2 groups: controls were defined as those without DE symptoms 6 months after surgery (defined by a Dry Eye Questionnaire 5 (DEQ5) score <6), cases were defined as those with mild or greater DE-like symptoms 6 months after surgery (DEQ5 ≥6).
Mean age of the study population was 71 ± 8.6 years; 95% (n = 82) were men. DE-like symptoms were reported in 32% (n = 27) of individuals 6 months after cataract surgery; 10% (n = 8) reported severe symptoms (DEQ5 ≥12). Patients with DE-like symptoms after cataract extraction also had higher ocular pain scores and specific ocular complaints (ocular burning, sensitivity to wind and light) compared with controls with no symptoms. A diagnosis of nonocular pain increased the risk of DE-like symptoms after cataract surgery (odds ratio 4.4, 95% confidence interval 1.58-12.1, P = 0.005).
Mild or greater PPP occurred in approximately 1/3 of individuals after cataract surgery. Prevalence of severe PPP is in line with that of refractive surgery, dental implants, and genitourinary procedures.
评估白内障手术后持续性手术疼痛（PPP）的发生率及危险因素，PPP定义为术后6个月出现轻度或更严重的干眼（DE）样症状。
这项单中心研究纳入了2016年6月至10月期间接受白内障手术且术后6个月有干眼症状信息的86例患者。患者分为两组：对照组定义为术后6个月无干眼症状者（根据干眼问卷5（DEQ5）评分<6确定），病例组定义为术后6个月有轻度或更严重干眼样症状者（DEQ5≥6）。
研究人群的平均年龄为71±8.6岁；95%（n = 82）为男性。白内障手术后6个月，32%（n = 27）的患者报告有干眼样症状；10%（n = 8）报告有严重症状（DEQ5≥12）。与无症状的对照组相比，白内障摘除术后有干眼样症状的患者眼部疼痛评分更高，并有特定的眼部不适（眼部烧灼感、对风和光敏感）。非眼部疼痛的诊断增加了白内障手术后出现干眼样症状的风险（比值比4.4，95%置信区间1.58 - 12.1，P = 0.005）。
白内障手术后约1/3的患者出现轻度或更严重的PPP。严重PPP的发生率与屈光手术、牙种植术和泌尿生殖系统手术的发生率相当。
