Preoperative Predictors for Acute Pain After Photorefractive Keratectomy : Cornea

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Preoperative Predictors for Acute Pain After Photorefractive Keratectomy

Toyota, Adriana M. COMT*; Garcia, Renato MD, PhD*; Torricelli, Andre A. M. MD, PhD*; Silva, Valquiria A. NUS, PhD; Galhardoni, Ricardo NUS, PhD; Teixeira, Manoel J. MD, PhD, DC; de Andrade, Daniel C. MD, PhD; Bechara, Samir J. MD, PhD*

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Cornea 41(8):p 940-949, August 2022. | DOI: 10.1097/ICO.0000000000003037



The aim of this study was to identify preoperative predictors for the occurrence of early severe postoperative pain in patients undergoing photorefractive keratectomy (PRK). The implementation of preoperative screening methods may facilitate more specific or aggressive pain therapies specifically targeted to individuals at a high risk of experiencing severe postoperative pain.


This was exploratory research that included patients who underwent PRK. Before PRK, patients were administered a sociodemographic questionnaire, the Pain Catastrophizing Scale, and the State-Trait Anxiety Inventory and underwent corneal sensitivity and conditioned pain modulation (CPM) tests. Post-PRK pain was assessed using a pain intensity visual analog scale (VAS), and the short-form McGill Pain Questionnaire (SF-MPQ) was completed 21 days before PRK and 1, 24, 48, and 72 hours after PRK. Spearman correlations were calculated for pain scores and preoperative predictors.


This research included 34 eyes of 34 patients. Preoperative corneal sensitivity was positively correlated with post-PRK pain scores as assessed by VAS and SF-MPQ (rho = 0.39 and rho = 0.41, respectively, P < 0.05). No correlations were found between Pain Catastrophizing Scale, State-Trait Anxiety Inventory, and CPM scores and post-PRK pain scores (P > 0.05).


Abnormal presurgical corneal sensitivity was a protective marker for severe pain after PRK, while scores as assessed by VAS and SF-MPQ and CPM were not related to postoperative pain.

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