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Lee, Ahn, Chung, and Chung: Predictable Factors of Postoperative Pain Following LASEK
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2010; 51(9): 1203-1209.

Published online: 30 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.9.1203

Predictable Factors of Postoperative Pain Following LASEK

Jung-Hye Lee, MD1, Kyeon Ahn, MD2, Eui-Sang Chung, MD, PhD1, Tae-Young Chung, MD, PhD1

1Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

2AK Eye Clinic, Daegu, Korea.

Address reprint requests to Tae-Young Chung, MD, PhD. Department of Ophthalmology, Samsung Medical Center, #50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel: 82-2-3410-6776, Fax: 82-2-3410-0049, tychung@skku.edu

Received 19 April 2010       Accepted 1 July 2010

Copyright © 2010 The Korean Ophthalmological Society

Abstract

Purpose

To determine predictable factors of postoperative pain and cut-off values following LASEK eye surgery.

Methods

Thirty-three eyes of 17 patients who underwent LASEK from May to December 2008 were reviewed. For evaluation of predictive factors, patients' anxiety level was converted to APAIS, HADS, STAI, and VAS preoperatively. Substance P and prostaglandin E2 levels in tears, blood pressure, heart rate, and history of any previous surgery were determined before the procedure. Thirty minutes and 1 day after LASEK, the subjective degree of pain was scored.

Results

Patients with high Amsterdam preoperative anxiety scale (APAIS) and Visual analogue scale (VAS) scores showed more postoperative pain (p=0.04, p<0.001). Higher substance P and prostaglandin E2 levels were significantly related with more severe pain after LASEK (p<0.001, p<0.001). Postoperative pain increased significantly, according to cut-off values (p<0.05), APAIS and VAS scores greater than 6, substance P greater than 631.84 pg/ml, and prostaglandin E2 greater than 783.90 pg/ml.

Conclusions

The level of pain after LASEK surgery varies individually, and many factors, including physical and psychological variances, can affect the pain. With higher APAIS/VAS scores and higher concentrations of substance P, prostaglandin E2 portends more severe pain following LASEK.

Keywords: Anxiety, LASEK, Predictable factors, Postoperative pain

Figures and Tables

Figure 1
Questionnaires for subjective scoring of anxiety.
jkos-51-1203-g001
Figure 2
Mean postoperative pain following LASEK.
*Postoperative pain measurement by VAS (Visual Analogue Scale); †P0 = pain at 30 minutes postoperatively; ‡P1 = pain at 1 day postoperatively; §PT = total pain (P0+P1).
jkos-51-1203-g002
Table 1
Predictive factors of postoperative pain following LASEK
jkos-51-1203-i001

*SBP = systolic blood pressure; †DBP = diastolic blood pressure; ‡HR = heart rate; §APAIS = Amsterdam preoperative anxiety information scale; ∥HADS = hospital anxiety anxiety depression scale; STAI = state-trait anxiety scale; #VAS = visual analogue scale; **SP = substance P; ††PGE2 = prostaglandin E2.

Table 2
Relations between predictive factors and postoperative pain after LASEK
jkos-51-1203-i002

*Pearson correlation analysis with Bonferroni correction; †P0 =pain at 30 minutes postoperatively; ‡APAIS = Amsterdam preoperative anxiety information scale; §VAS = visual analogue scale; ∥SP = substance P; PGE2 = prostaglandin E2; #P1 = pain at 1 day postoperatively; **PT = total pain (P0+P1).

Table 3
Cut-off values of predictive factors for postoperative pain after LASEK
jkos-51-1203-i003

*minimum p-value approach; †P0 = pain at 30 minutes postoperatively; ‡VAS = visual analogue scale; §P1 = pain at 1 day postoperatively; ∥APAIS = Amsterdam preoperative anxiety information scale; PT = total pain (P0 + P1)

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