Paik Dong Won, Lim Dong Hui, Chung Tae-Young
Department of Ophthalmology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea (the Republic of).
Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Seoul, Korea (the Republic of).
Br J Ophthalmol. 2022 Apr;106(4):474-479. doi: 10.1136/bjophthalmol-2020-317570. Epub 2020 Dec 10.
Corneal nerve damage after laser epithelial keratomileusis (LASEK) is thought to be the cause of dry eye and pain. Therefore, we investigated whether taking pregabalin (Lyrica), which reduces peripheral neuropathic pain, alleviates corneal nerve sensitivity after surgery and reduces dry eye and pain.
Patients were treated with pregabalin (150 mg two times a day for 15 days) from the day before surgery onward and compared with those who did not receive the medications. Before surgery, the severity of dry eye was assessed. Then, corneal sensitivity was assessed by esthesiometry and pain was assessed according to the Visual Analogue Scale. Images of the sub-basal nerve plexus were analysed using confocal microscopy to evaluate nerve regeneration at 6 months.
Forty eyes in the pregabalin group and 40 eyes in the control group were included in this study. No significant differences regarding the severity of dry eye, corneal sensitivity test results and nerve fibre density existed between the two groups until 6 months. The pregabalin group showed significantly reduced pain at 1 week.
Taking pregabalin during LASEK surgery may affect corneal nerve sensitivity and reduce pain. However, for up to 6 months thereafter, corneal sensitivity and nerve fibre density are not significantly different from findings in the control group, so pregabalin does not seem to affect nerve regeneration or structural changes.
准分子激光上皮下角膜磨镶术(LASEK)后角膜神经损伤被认为是干眼和疼痛的原因。因此,我们研究了服用可减轻周围神经性疼痛的普瑞巴林(乐瑞卡)是否能减轻术后角膜神经敏感性,并减轻干眼和疼痛。
患者从手术前一天开始服用普瑞巴林(每天两次,每次150mg,共15天),并与未接受药物治疗的患者进行比较。手术前,评估干眼的严重程度。然后,通过感觉测量法评估角膜敏感性,并根据视觉模拟量表评估疼痛程度。使用共聚焦显微镜分析基底膜下神经丛的图像,以评估6个月时的神经再生情况。
本研究纳入了普瑞巴林组的40只眼和对照组的40只眼。直到6个月时,两组在干眼严重程度、角膜敏感性测试结果和神经纤维密度方面均无显著差异。普瑞巴林组在1周时疼痛明显减轻。
在LASEK手术期间服用普瑞巴林可能会影响角膜神经敏感性并减轻疼痛。然而,在此后的6个月内,角膜敏感性和神经纤维密度与对照组的结果无显著差异,因此普瑞巴林似乎不会影响神经再生或结构变化。