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Opioids for Ocular Pain - A Narrative Review
Vinicius Bp Pereira1, Renato Garcia1, Andre Am Torricelli1
1São Paulo University Medical School, Ophthalmology Department, Refractive Surgery Service, Brazil.
Pain Physician
|July 21, 2017
Summary
Post-refractive surgery pain can be severe. While opioids are used for pain management, their benefits and risks require further evaluation in randomized clinical trials before widespread recommendation.
Area of Science:
- Ophthalmology
- Pain Management
- Pharmacology
Background:
- Refractive surgery, including photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK), is a common procedure.
- Severe post-operative pain can be a significant complication following refractive surgery.
Purpose of the Study:
- To review existing literature on the use of opioids for managing post-operative pain after ocular surgery, with a specific focus on refractive procedures.
- To explore the physiology of corneal pain and current analgesic strategies.
Main Methods:
- A narrative review of articles published between January 1985 and May 2015 was conducted using PubMed.
- Studies focusing on PRK and LASIK, including reviews, meta-analyses, and randomized clinical trials, were included.
- The search targeted the physiopathology of corneal pain and opioid treatment post-refractive surgery.
Main Results:
- Out of 109 initially identified articles, 75 met the inclusion criteria.
- Pain after refractive surgery is multifactorial, often managed with topical and systemic analgesics.
- No studies directly assessed opioid benefits for PRK pain, though opioids are sometimes prescribed.
Conclusions:
- Opioids are utilized for short-term pain relief after refractive surgery.
- Further randomized clinical trials are necessary to establish the definitive benefits and risks of opioid use in this context.
- Evidence-based guidelines for opioid analgesia in post-refractive surgery pain are currently lacking.
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