Prevalence and risk factors for the development of chronic postoperative pain after cataract surgery in the Age-related Eye Disease Study (AREDS)

Chronic ocular pain impacts quality of life and is often linked to ocular surgery. We assessed the prevalence of chronic postoperative pain (CPOP) after cataract surgery and associated risk factors using a secondary cohort post-hoc analysis of data from the Age-Related Eye Disease Study (AREDS), a multicenter, controlled, randomized clinical trial of antioxidant vitamins and minerals. Ocular pain was determined from item 4 of the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), administered between 1997 and 2005. We included participants who underwent cataract surgery during the study and reported no or mild ocular pain before first-eye cataract surgery (n=325). Controls (n=283) reported no or mild ocular pain 3 or more months after first-eye cataract surgery; cases (n=42) reported moderate or severe pain 3 or more months after first-eye cataract surgery. Multivariable logistic regression models assessed associations between potential risk factors (age, sex, body mass index, smoking, diabetes, education level, use of anti-inflammatory agents, use of antacids, general health, AREDS treatment group) and CPOP. Of the 325 participants (mean age, 69.7±4.4 years, 59.4 % female); CPOP developed in 42 (13 %; 95 % CI, 9.3 – 16.6 %). The average time between cataract surgery and the post-surgery VFQ was 18.4±11.8 months (range 3.0 – 65.0 months). Multivariable analysis did not reveal any statistically significant associations with odds of developing CPOP after cataract surgery. As such, in this AREDS cohort who underwent cataract surgery, 13% developed CPOP, consistent with previous reports from cataract and refractive surgery. Our post-hoc analyses did not identify any significant risk factors for CPOP.

Perspective

We found a high prevalence of Chronic Postoperative Pain (CPOP) in the AREDS cohort, with 13 % of participants who underwent cataract surgery developing CPOP. Post-hoc analysis did not identify significant risk factors for CPOP. Our study contributes valuable insights into a growing area of interest in pain management within ophthalmology.