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Pain after corneal cross-linking in patients treated with acetaminophen and metamizole: a pilot study

Poster Details

First Author: E.Quiroga SPAIN

Co Author(s):    N. Alejandre                    

Abstract Details


Corneal crosslinking (CXL) is used to stabilize progressive keratoconus, halting further thinning and protrusion. The standard technique requires de-epithelization with subsequent pain in the first postoperative days. The purpose of this study is to study the effectiveness of acetaminophen 1 gram (g) combined with metamizole 575 miligrams (mg) controlling the pain after CXL.


Observational prospective study. Ophthalmology department, Fundación Jimenez Diaz Hospital,Madrid, Spain


After CXL, patients were treated for 4 days with acetaminophen 1 g and metamizole 575 mg each 8 hours, in addition to topic treatment with antibiotic and corticoesteroids eye drops. To evaluate the pain, each patient completed a visual analogue scale (VAS) every 8 hours during the four days after CXL. Demographic (age and gender) and tomographic characteristics (maximum keratometric reading and central corneal thickness) were recorded for the statistical analysis.


14 eyes of 14 patients completed the study. Mean patient age was 23.9 ± 8.1 years. Mean patient-scored pain on first day was 6.8 ± 3.3 (intensive pain at VAS). Apparently the only demographic factor influencing postoperative pain was age. Patients with 19 years and under >19 years scored 4.4 ± 3.4 while patients over 19 years scored 8.1 ± 2.5 (P< 0.05) on the first postoperative day. There was not significant relation between intensive pain and preoperative maximun keratometry (P = 0.572) or the thinnest point (P = 0.7546). We can not analize differences between gender because there was only one woman in the sample.


Treatment with acetaminophen and metamizol failed to obtain optimal control of postoperative pain after CXL on the first day. On the other hand it may be a good choice in young patient. There is a need for randomized clinical trials to clarify the best treatment to control the pain after CXL.

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