THE BELGIAN OPHTHALMIC ASSOCIATIONS
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| Presentation type | E-poster |
| Title | Postoperative pain management in pterygium excision |
| Purpose | Pterygia are fibrovascular conjunctival overgrowth that can cause discomfort, sensation of pressure and tearing. Symptoms tend to exacerbate after excision, resulting in longer recovery times and lower patient satisfaction. Despite technical improvement, (i.e. P.E.R.F.E.C.T.), postoperative pain management remains an issue. Our aim was to determine the best EBM surgical anaesthetic protocol to reduce postoperative pain and discomfort. |
| Methods | We reviewed literature with an emphasis on anaesthetic choice measured by objective and subjective outcomes. By using 'Postoperative pain', 'Pterygium' and 'Excision' as search parameters, we identified 92 relevant articles and used 8. We investigated the best manner of analysing postoperative pain and irritation as well as efficacy of (combined) sodium hyaluronate, AS, cyclopentolate among others. |
| Results | The OSDI score was the most standardized tool to measure subjective discomfort. Mean postoperative VAS scores were up to 3 units lower depending on intervention. Peroperative use of combined sodium hyaluronate and xantham gum was the most effective, though only on subjective reports. Peroperative lidocaine gel resulted in 3 times lower VAS score, topical morphine eyedrops resulted in decreased oral anaethetic use. Postoperative cyclopentolate and AS resulted in a decrease of respectively 1 and 1.6 VAS score units. |
| Conclusion | Postoperative pain control after pterygium excision is crucial to patient satisfactory and easily improved by anaesthetic choice. The review concludes that lidocaine gel gives an excellent pain control and can reduce postoperative OSDI score. Hence, we will start a prospective clinical trial to examine the use of lidocaine gel in pterygium excision (NCT05978687). |
| Conflict of interest | Yes |
| Details of conflicting interests | VUB/ UZ BrusseL |
Authors 1
| Last name | HELLINCKX |
| Initials | L |
| Department | Vrije Universiteit Brussel/ UZ Brussel |
| City | Brussel |