Evaluation of early postoperative ocular pain after photorefractive keratectomy and corneal crosslinking

Purpose: To evaluate and compare early postoperative pain after photorefractive keratectomy (PRK) and corneal crosslinking (CXL). Setting: Khatam-al-Anbia Eye Hospital, Mashhad, Iran. Design: Prospective case series. Methods: The PRK group included patients with simple refractive errors whereas the CXL group included patients with clinical keratoconus. The groups were compared regarding the level of pain based on the visual analogue scale (VAS), verbal rating scale (VRS), and Wong-Baker FACES pain rating scale immediately after surgery, 6 hours postoperatively, and 1, 3, and 7 days postoperatively. The epithelial defect size was measured at 6 hours after surgery and 1 day and 3 days after surgery in both groups. Results: The study comprised 68 patients (34 patients in the PRK group and 34 patients in the CXL group). The epithelial defect size was significantly smaller in the CXL group than in the PRK group (P < .001); however, the amount of pain was significantly higher after CXL than after PRK based on VAS and VRS (P = .04 and P = .019, respectively). In the FACES scaling system, the pain score was also higher in the CXL group than in the PRK group. However, the difference was not statistically significant. No intraoperative or postoperative complications were observed during follow-up. Conclusions: The epithelial defect healing rate was statistically significantly faster in the CXL group than in the PRK group. However, the level of pain was greater in the CXL group, suggesting that postsurgical pain might be influenced by other factors than the epithelial defect. (C) 2018 ASCRS and ESCRS