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Persistent socket pain postenucleation and post evisceration: a systematic review.

Charlotte S E Hogeboom1, Daphne L Mourits1, Johannes C F Ket2

  • 1Department of Ophthalmology, VU University Medical Center, Amsterdam, The Netherlands.

Acta Ophthalmologica
|April 11, 2018
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Summary
This summary is machine-generated.

Persistent socket pain (PSP) after eye removal is often multifactorial, with phantom pain being the most common cause. While some conditions like trochleitis and dry socket respond to conservative treatments, others may necessitate surgical intervention, such as implant removal.

Keywords:
chronic painenucleationeviscerationpain treatmentsocket

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Area of Science:

  • Ophthalmology
  • Ophthalmic Surgery
  • Pain Management

Background:

  • Persistent socket pain (PSP) following enucleation or evisceration presents a significant clinical challenge.
  • Understanding the diverse etiologies of PSP is crucial for effective patient management.

Purpose of the Study:

  • To systematically investigate the causes, diagnostic methods, and treatment strategies for persistent socket pain (PSP) after enucleation and evisceration.

Main Methods:

  • A systematic literature search was conducted across major databases (PubMed, Embase, Web of Science) up to July 2016.
  • Inclusion criteria focused on patients with PSP post-enucleation/evisceration, reporting causes, diagnostics, or treatments.
  • Evidence from primary observational studies was assessed due to the scarcity of high-quality randomized controlled trials.

Main Results:

  • Thirty-two studies were included, identifying various causes of PSP including neuromas (8), inflammation (5), surgery-related factors (4), prosthesis-related issues (5), dry socket (2), trochleitis (3), trigeminal nerve compression (2), malignant tumors (3), psychiatric factors (2), and rarer entities (3).
  • Phantom pain was the most frequently reported cause (149 cases).
  • Nonsurgical treatments were effective for trochleitis, prosthesis-related pain, dry socket, and phantom pain, while implant removal was indicated for other causes.

Conclusions:

  • PSP is likely multifactorial, with origins sometimes remaining uncertain despite thorough evaluation.
  • Implant replacement can be an effective therapeutic option for specific PSP cases.
  • Further research is needed to identify and validate less invasive treatment procedures for PSP.