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Global Translational Medicine Neuropathic pain after 23-gauge sclerotomy

with various domains of personal life such as general (4%). There were patients with more than one underlying
activity, mood, relationships, sleep, enjoyment of life, the condition at baseline. No post-operative complications
ability to walk, and the ability to perform daily work both such as uveitis, corneal epithelial defect, punctate epithelial
outside and inside the home. The patients rated them erosion, significant ocular surface inflammation, or
through an 11-point numeric scale (“0” corresponds to no conjunctival injection were observed during follow-up
interference, and “10” shows complete interference). examinations.
The effect of demographic characteristics (such as The prevalence and intensity of pain-related symptoms
patient’s age, gender, and level of education), as well as in eyes, as well as headache and facial numbness, were
background systemic conditions such as diabetes mellitus, compared before and after surgery. Figure 1 depicts the
hypertension, chronic back pain, musculoskeletal pain, individual scatterplot of each score before and after surgery.
migraine headaches, depression, type of surgery, and Although the frequency of some symptoms such as deep
method of anesthesia on reported ocular symptoms and eye pain, photophobia, and facial numbness increased
quality of life were investigated. The level of education of after surgery, the difference between patient-reported pain
participants was classified into four levels: illiterate, not scores and other symptoms’ scores before and after surgery
completed high school, with a high school diploma, and was not statistically significant (Table 1). Likewise, the
with a college degree. quality-of-life scores at baseline and 2 months following
The collected data were analyzed using IBM SPSS surgery did not show a significant change (Table 2).
Statistics for Windows, version 23 (IBM Corp., Armonk, Overall, eye symptoms at 2 months after surgery were
N.Y., USA). The normal distribution of quantitative not correlated with age and sex, but significantly varied
variables was evaluated with the Smirnov–Kolmogorov among different levels of education (illiterate: 0.92 ±
test. Paired t-test or Wilcoxon test was used to compare 0.74; not completed high school: 1.40 ± 1.36; high school
the alteration of each score after surgery based on the diploma: 1.63 ± 2.58; college degree: 0.17 ± 0.44; P = 0.044).
normality of the variables. To determine the distribution The presence of systemic diseases such as diabetes (mean
of categorical factors, the Chi-square test was applied. The pain score: 1.52 ± 2.36), musculoskeletal pain (mean pain
regression model was used to determine the association score: 1.06 ± 1.63) and depression (mean pain score: 1.39 ±
of various predicting factors with post-operative overall 2.12) was not associated with the overall eye pain scores in
eye pain score. To evaluate the association of a covariate the post-operative period. However, a history of migraine
with a dichotomous dependent variable, logistic regression headaches could increase the overall post-operative eye
analysis was employed. The significance level of the test pain score (B: 1.35; 95% CI: 0.25 – 2.45; P = 0.017). The
was set at 0.05. method of anesthesia (local or general) and type of surgery

3. Results (vitrectomy or silicone oil removal surgery) did not affect
eye symptoms 2 months after surgery.
A total of 75 eyes of 75 patients, including 31 (41%)
females, were enrolled in this study. The average age of Using systemic analgesics like non-steroidal anti-
participants was 58.93 ± 12.05 (range: 35 – 82) years. Sixty- inflammatory drugs (NSAIDs) for eye symptoms increased
seven (89.3%) patients underwent 23G vitrectomy, and from 4% at baseline to 17.33%, 2 months after surgery
8 (10.7%) patients had 23G silicone oil removal surgery. (P = 0.021). We found a weak positive correlation between
Sixty (80%) patients (52 patients underwent vitrectomy post-operative analgesic usage and pre-operative eye pain
and eight patients had silicone removal surgery) received score, photophobia, and face pain, but such significance was
regional anesthesia (subtenon or retrobulbar block), and not found with foreign body sensation and tearing (Table 3).
15 (20%) (underwent 23G vitrectomy) received general In a subgroup analysis, patients who had analgesic
anesthesia. consumption 2 months after surgery scored worse in
The distribution of the level of education of participants items of quality-of-life questionnaire. They reported a
was as follows: 8% were illiterate, 29.3% did not complete significantly higher rate of disturbance in general activity,
high school, 29.3% had a high school diploma, and 9.3% mood, normal work, relationship with others, sleep, and
had a college degree. The underlying condition at baseline life enjoyment compared to those who were not using
included 28 patients diagnosed with diabetes mellitus analgesics postoperatively (Table 4).
(37.3%), 30 patients with hypertension (40%), 29 patients 4. Discussion
with chronic back pain (38.7%), 29 patients with
musculoskeletal pain (38.7%), 11 patients with migraine In the present study, we showed that 23-gauge sclerotomy
headache (14.7%), and three patients with depression did not alter ocular pain scores significantly. Among the

Volume 3 Issue 2 (2024) 3 doi: 10.36922/gtm.1770