OPIOID SYSTEM AND OCULAR SURFACE PAIN

Published 2022 - 26th ESCRS Winter Meeting

Reference: P155 | Type: Abstracts | DOI: 10.82333/0wnr-zt91

Authors: Celia García-López* ¹ , Carlos Rocha-de-Lossada ¹ , Carmen Gómez-Huertas ¹ , Marina Rodríguez-Calvo-de-Mora ¹ , Vito Romano ² , Rahul Rachwani ³ , Juan Francisco Ramos-López ¹ , Santiago Ortiz-Pérez ¹

¹Ophthalmology,University Hospital Virgen de las Nieves, Granada, Spain,Granada,Spain, ²Ophthalmology,Department of Eye and Vision Science, institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK,Liverpool,United Kingdom, ³Ophthalmology,Hospital Regional Universitario de Malaga, Malaga, Spain,Malaga ,Spain

Purpose

This review attempts to collect the literature about corneal surface and opioid pathways to provide an overview image and a possible direction of the new treatments.

Setting

Single tertiary center, University Hospital Virgen de las Nieves, Granada, Spain.

Methods

A Pubmed search was conducted for relevant studies on the physiopathology of role of opioids on the cornea and the use of opioids for treating ocular surface problems. The search was for studies published from 1990 to 2021, including basic sciences studies, randomized clinical trials and reviews. Inclusion criteria of this narrative review were focused on the function of opioids controlling different types of pain and new vias of treatment.

Results

In daily use, systemic opioids are used as painkillers. The use of weak opioids such us codeine or tramadol have decreased the associated side effects. Corneal surface for topical treatment is easily accessible hence sparing the side effects of systemic opioids. Topical opioidstreatments such us morphine or codeine have been accomplished for the control of postoperative and inflammatory pain with mixed incomes. Especially in centralized pain, oral low dosage of naltrexone produces a rebound effect of endogenous opioidsachieving an analgesic effect and other protentional benefit in dry eye and neuropathic pain. The inhibition of catabolic enzymes of endogenous opioids in the cornea enables to increase the natural opioid actions and new and specific agonists, especially MOR agonists, expand the possibilities to enhance the analgesia.

Conclusion

In the cornea, opioid system has a role in the control of the different stages of the pain. The manipulations of these pathways, with antagonists or agonists oral opioids and topical treatment, imply a new vias of controlling it, especially in neuropathic pain.