Question Title: chronic eye pain following cataract surgery

Posted by srb on July 29, 1999 at 23:02:00

I originally had cataract surgery on my right eye in Sept'97 which was more complicated than anticipated and required an anterior chamber lens placement due to lack of capular support for a posterior chamber lens. My postoperative course was characterized by increasing pain and blurred vision and after treatment by injection and a variety of medications, testing revealed presence of cystiod macular edema. After several months of treatment, including further injections, the cme cleared but not the pain and blurred vision. A corneal topography suggested possiblity of kerataconus and thereafter we tried several months of treatment with gas permeable and then soft perm contact lens.(both eyes) Unfortunately, I was not able to tolerate those lenses and they produced further irritation and additional cme. Finally in June of 1998, after continuing pain and blurred vision, my opthalmologist suggested I might benefit from an intraocular lens exchange to a posterior position. Unfortunately this postoperative course was more traumatic than the initial surgery, requiring 3 separate suture repairs for fluid leakage in the first week.
While my visual accuity has gradually improved the pain has been constant and has gotten progressively more severe, now spreading to both eyes. Symptoms are daily and constant characterized by burning and sensation that eyes are engulfed in fluid. Condition always worsens(winds up) as day progresses. My opthalmologist says he can find no occular reason for my continuing pain and I have been seeing neurologist and pain management specialists since Aug 1998. Have had at least 5 different nerve blocks and numerous medications(anti-convusive & anti seizure) none of which have had any positive effect. My current doctors seem to believe pain is neuropathic in origin but admit they are not certain and have been unable to give me any real reason for optimism. No one seems to have run across similar situation which adds to my growing frustration. I am now seeing several doctors at a NC academic institution, but the lack of progress causes me to seek any further insights including recommendations for further research/care which may be available.

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Posted by HFHS MD - NI on July 29, 1999 at 23:28:48

In rare cases, it is possible for an intraocular lens to cause eye pain. This was more common when the first generation of intraocular lenses were made in the 70's and 80's. With newer technology, this is very rarely seen. It is unlikely to be the cause of pain in you as you had an IOL exchange and still have pain. The pain you describe of burning and watering sounds like ocular surface pain rather than intraocular pain. Since it is in both eyes, the surgeries are less likely to be the cause. Dry eye may be possible. There are several excellent ophthalmologist at the academic centers in NC and I am sure they should be able to help you.

This information is for educational purposes only.

Please maintain followup with your ophthalmologist.

HFHS MD - NI

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