Long-lasting pain after laser eye surgery is linked to tear proteins

The revolutionary advancements in surgical procedures for correcting vision issues have made it possible to alter the eye to improve light focus. Although these procedures, including laser techniques, are generally considered safe, some individuals may experience prolonged pain as a side effect.

A recent study in the ACS Journal of Proteome Research has revealed a groundbreaking connection between changes in tear proteins and long-term post-surgery pain. This analysis has the potential to identify individuals at risk by detecting shifts in specific protein levels.

When the eye cannot focus light properly onto the retina’s sensory cells, it leads to impaired vision. Surgeons use laser technology in procedures like laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) to change the path of light heading to the retina, by reshaping the cornea, the transparent covering of the eye.

Pain is common in the first few days following the procedure and can sometimes persist for an extended period. Researchers believe that long-lasting pain may be connected to changes in the internal environment around the corneal nerves, including the tears that keep the eye moist. Sue Aicher, Brooke Harkness, Anat Galor, and their team chose to thoroughly examine tear proteins to identify potential indicators of post-operative eye pain.

The team conducted a study on patients undergoing LASIK or PRK in Portland, Oregon, and Miami. They focused on analyzing tears from 16 patients who experienced post-operative pain and 32 patients who reported no pain three months after surgery.

After identifying 2,748 proteins in the participants’ tears before surgery, the day after, and three months after surgery, the researchers detected 83 proteins whose levels changed among patients with postoperative pain. Using statistical analysis, they tested whether these proteins could predict long-term pain. The models using sets of three or four proteins were found to be the most effective at predicting discomfort.

The researchers believe that these protein differences could potentially be used to assess patients’ risk of post-surgical eye pain and explore new treatment options in the future.

Journal reference:

Brooke M. Harkness, Siting Chen, Kilsun Kim, Ashok P. Reddy, Trevor J. McFarland, Deborah M. Hegarty, Steven J. Everist, Julie A. Saugstad, Jodi Lapidus, Anat Galor, and Sue A. Aicher. Tear Proteins Altered in Patients with Persistent Eye Pain after Refractive Surgery: Biomarker Candidate Discovery. Journal of Proteome Research, 2024; DOI: 10.1021/acs.jproteome.4c00339

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