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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

Purpose:

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.

Setting:

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

Methods:

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.

Results:

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.

Conclusions:

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.

Financial Disclosure:

NONE

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