Post-op CXL pain linked to age

Collagen cross-linking (CXL) can cause more intense postoperative pain in younger patients, according to a paper published in Cornea.

Dr Vinícius Ghanem et al., Cornea Department, Sadalla Amin Ghanem Eye Hospital, Joinville, Brazil, conducted a prospective study on 178 consecutive eyes of 135 patients with progressive keratoconus who underwent CXL.

The need for analgaesia with 30 mg of codeine and subjective self-evaluation was used to assess postoperative pain. Subjective evaluation was completed using the Wong-Baker FACES Pain Rating Scale at the end of each postoperative (PO) day for five days. The correlation between postoperative pain/keratometric readings and central corneal thickness (CCT) was assessed preoperatively.

The results revealed the mean number of codeine pills administered was 0.94, 0.72 and 0.28 at iPO, PO1 and PO2, respectively. There was a significant link between age and pain at PO3 and PO4 and between age and number of codeine pills on iPO. However, there was no significant association between mean overall pain and preoperative apical keratometry and pachymetry readings.

After CXL, pain is especially intense in particular during the first three postoperative days, despite aggressive pain control regimens. However, on each consecutive day, pain and the need for analgaesia decreased significantly.

The abstract can be viewed here.