Abstract Listings 2024

Effect of Superficial Keratotomy on Reducing Postoperative Pain Following Conjunctival Flap Surgery: A Double-Blind Randomized Controlled Trial

Author: Nasser Karimi
Base Hospital / Institution: Rassoul Akram Hospital / Iran University of Medical Sciences

Rapid fire oral presentation

Abstract ID: 24-317

Purpose

To determine if adding superficial keratotomy to the standard conjunctival flap method reduces postoperative pain.


Methods

In this double-blind randomized trial (ClinicalTrials.gov, NCT05494931), patients undergoing conjunctival flap surgery for prosthesis fitting, were assigned to either the control group (classical Gunderson method) or the intervention group (classical method plus superficial corneal neurotomy). Randomization used balanced quadruple blocks. Pain scores were measured using a visual analog scale (0-10) at 6, 24, and 48 hours postoperatively. The assessor was blinded to group assignment. Initial sample size was 16 patients, with an interim analysis planned after 9 patients. Successful prosthesis fixation, surgical complications, and need for reoperation were recorded during follow-up visits and calls.


Results

Pain scores were significantly lower in the intervention group (N=5) compared to the control group (N=4) at 6 hours (1.0 vs 8.0, P=0.02), 24 hours (1.0 vs 2.5, P=0.02), and 48 hours (0.0 vs 2.5, P=0.04). No significant differences in age, sex, education, ethnicity, previous ocular surgeries, or smoking history were found between groups. Median horizontal and vertical corneal diameters were similar (10.5 mm and 9 mm; P = 0.80 and P = 0.25, respectively). No flap retractions occurred during follow-up (median 7 months), but one control group patient developed small peripheral buttonholes that did not require surgical revision.


Conclusion

Superficial corneal neurotomy effectively reduces pain following conjunctival flap surgery, with no observed complications.


Additional Authors

First name Last name Base Hospital / Institution
Shahrzad Pakzadian Rassoul Akram Hospital / Iran University of Medical Sciences
Sahar Askari Rassoul Akram Hospital / Iran University of Medical Sciences
Mohsen Kashkouli Kentucky Lions Eye Center, University of Louisville School of Medicine

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