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Masked trial of topical anesthesia for retinopathy of prematurity eye examinations
Martin S Cogen1, Jack S Parker, Todd E Sleep
1Department of Ophthalmology, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama 35233, USA. mcogen@uab.edu
Insights
Topical anesthetic use in premature infants undergoing retinopathy of prematurity (ROP) examinations appears to reduce pain. This intervention showed no adverse effects on corneal clarity during these crucial eye exams.
Area of Science:
- Ophthalmology
- Neonatal Care
- Pain Management
Background:
- Retinopathy of prematurity (ROP) requires regular eye examinations in premature infants.
- Assessing pain and corneal clarity during ROP examinations is critical for infant well-being and diagnostic accuracy.
Purpose of the Study:
- To evaluate the impact of a topical anesthetic on pain and corneal clarity in premature infants during ROP examinations.
- To compare the efficacy of proparacaine 0.5% versus artificial tears for pain reduction.
Main Methods:
- Premature infants undergoing ROP examinations were randomized.
- One eye received proparacaine 0.5% or artificial tears; the other received artificial tears.
- Pain was assessed using the Premature Infant Pain Profile (PIPP); corneal clarity was compared between eyes.
Main Results:
- A topical anesthetic (proparacaine 0.5%) was associated with a lower incidence of painful events (27% vs. 65%).
- Mean PIPP scores were lower in the anesthetic group (8.8 vs. 10.4), though not statistically significant (p=0.17).
- No adverse effects on corneal clarity were observed with anesthetic use.
Conclusions:
- Topical anesthetic use may offer a marginal decrease in pain during ROP examinations.
- Proparacaine 0.5% does not negatively impact corneal clarity in this population.
- Anesthetics are a safe option for managing pain during ROP screening.
Purpose:
To observe the effect of a topical anesthetic on pain and corneal clarity in premature infants undergoing eye examinations for retinopathy of prematurity (ROP).
Methods:
ROP examinations were performed on premature infants who were randomized to receive either proparacaine 0.5% or an artificial tear solution in the right eye. All infants received an artificial tear solution in the left eye. Assessment of discomfort was performed by use of the Premature Infant Pain Profile (PIPP) during examination of the right eye, with a painful event defined as a PIPP score≥11. The left eye was then examined and a comparison of corneal clarity was made between the 2 eyes.
Results:
A total of 39 examinations were performed on 34 infants: artificial tear solution was administered 17 times and topical proparacaine anesthetic 22 times. The mean PIPP score for those receiving artificial tears was 10.4 compared with 8.8 for the anesthetic group (p=0.17). Of the examinations without anesthetic, 65% were painful, compared with 27% with anesthetic (p=0.04). No effect on corneal clarity was observed in any examination.
Conclusions:
The use of a topical anesthetic appears to marginally decrease pain and has no adverse effect on subjectively assessed corneal clarity during examination of premature infants for ROP.
