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Graefe's Archive for Clinical and Experimental Ophthalmology

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01-10-2019 | Analgesics in Dentistry | Cornea

Postoperative pain following Descemet membrane endothelial keratoplasty (DMEK): a prospective study

Authors: Johannes Loeser, Julian Schwemmer, Antoniu-Oreste Gostian, Magdalena Gostian, Björn Bachmann, Claus Cursiefen, Ludwig M. Heindl

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2019

Abstract

Purpose

To evaluate postoperative pain following Descemet membrane endothelial keratoplasty (DMEK).

Methods

Seventy-one patients completed perioperatively (day before surgery, day of surgery, 1st, 2nd, and 3rd day after surgery) four different questionnaires (a hospital internal protocol, QUIPS, PainDETECT®, and SF36) regarding their pain and other clinical parameters such as constipation, tiredness, vertigo, sleep disorders, concentration disorders, nausea, and emesis. All standardised questionnaires were evaluated to quantify average pain intensity as well as maximum pain intensity (NRS, 0 [no pain] to 10 [maximal pain], respectively). Analgesic treatment and intraocular pressure (IOP) during the perioperative stay were documented.

Results

Mean average pain intensity was 0.70 ± 1.64 before surgery, 1.97 ± 2.05 on the day of surgery, 1.39 ± 1.68 on day 1, 0.87 ± 1.36 on day 2, and 0.81 ± 1.24 on day 3 after surgery. Maximum pain intensity was 0.65 ± 1.81 before surgery, 3.35 ± 2.98 on the day of surgery, 2.68 ± 2.99 on day 1, 1.49 ± 2.15 on day 2, and 1.26 ± 2.02 on day 3 after surgery. During the first three postoperative days, over 90% of the patients stated no or well tolerable pain. Eighty-three percent had postoperatively no need for analgesics at all. On the first two postoperative days, maximum IOP correlated significantly with reported increased maximum pain intensity (p = 0.043 and p = 0.029, respectively). All patients had very little problems with constipation, tiredness, vertigo, sleep disorder, concentration disorders, nausea, and emesis.

Conclusions

DMEK is associated with low postoperative pain intensity. Strong pain increase may indicate IOP elevation and should be further investigated and treated.

Clinical trial registration

German Clinical Trial Register (DRKS00013995)

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Title: Postoperative pain following Descemet membrane endothelial keratoplasty (DMEK): a prospective study
Authors: Johannes Loeser
Julian Schwemmer
Antoniu-Oreste Gostian
Magdalena Gostian
Björn Bachmann
Claus Cursiefen
Ludwig M. Heindl
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Analgesics in Dentistry
Keratoplasty
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2019
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-019-04437-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Postoperative pain following Descemet membrane endothelial keratoplasty (DMEK): a prospective study

Abstract

Purpose

Methods

Results

Conclusions

Clinical trial registration

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Clinical trial registration

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