Dynamic monocyte chemoattractant protein-1 level as predictors of perceived pain during first and second phacoemulsification eye surgeries in patients with bilateral cataract

Feng Zhang,Jin-Hua Wang,Mei-Sheng Zhao

doi:10.1186/s12886-021-01880-z

Abstract

BackgroundThe purpose of the study was to investigate whether dynamic monocyte chemoattractant protein-1 (MCP-1) level might be as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract.MethodsConsecutive bilateral cataract patients undergoing bilateral sequential phacoemulsification were retrospectively enrolled. Patients’ preoperative anxiety score and intraoperative pain score were registered. Aqueous humor samples were obtained during surgery. MCP-1 level in the aqueous humor was measured by enzyme linked immunosorbent assay (Elisa). Patients were assigned to seven subgroups based on the interval between first-eye and second-eye cataract surgery. Comparisons were performed for a subjective sensation and MCP-1 levels among different subgroups.Resultspain score during second-eye surgery was significantly higher than during first-eye surgery. Whereas there was no statistical difference in anxiety score between both surgeries. Result from subgroups comparison showed that the visual analog scale (VAS) pain score was statistically greater in 1-group and 6-group during the second eye surgery. Anxiety score did not statistically differ in subgroups. Additionally, the second-eye MCP-1 level was significantly higher at week 1and 6 intervals. Preoperative MCP-1 level was positively correlated with perceiving pain score during both surgeries.ConclusionsMCP-1 level in aqueous humor significantly correlated with perceived pain during cataract surgery. Dynamic MCP-1 level could function as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract, which might support clinicians in treatment optimization and clinical decision-making.

Highlights

The purpose of the study was to investigate whether dynamic monocyte chemoattractant protein-1 (MCP-1) level might be as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract
MCP-1 level across all the subgroups significantly correlated with the visual analog scale (VAS) pain score in the second-eye cataract
It is common observation that bilateral cataract patients undergoing sequential phacoemulsification with intralobular foldable lens (IOL) implantation might experience more painful sensation during second-eye surgery, even though both procedures were performed by a same clinician and under same condition [27]

Summary

Introduction

The purpose of the study was to investigate whether dynamic monocyte chemoattractant protein-1 (MCP-1) level might be as predictors of perceived pain during the first and second phacoemulsification eye surgeries in patients with bilateral cataract. Since the 1990s, cataract surgery has progressed to the modern technique of phacoemulsification that involves a small corneal incision and the implantation of an intralobular foldable lens (IOL). This surgical procedure no longer requires complete akinesia, encouraging the use of less invasive anesthetic modalities [4]. Phacoemulsification with IOL under topical anesthesia is widely performed to treat cataract, as it has several advantages such as avoidance of postoperative ptosis or diplopia, immediate visual recovery, decreased patients’ anxiety, shorter operative time, improved intraoperative patient cooperation, and better safety [8, 9]. Consecutive operation at intervals might be an ideal approach for treating patients with bilateral cataracts [10]

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