How much pain after cornea surgery?

February 25, 2011 5:42 PM

I am scheduled for a superficial keratectomy mid-March. What can I expect as far as pain after the procedure as well any insight anyone can give me regarding going through the actual procedure.

I'm getting a super K to correct corneal erosion. I am having cornea tears on average 3-4 times a week. In this procedure, the doctor is removing part of my cornea and "roughing up" the rest in an effort to eliminate a lot of my scarring. I know all too well about the pain of a cornea tear (or puncture - dog stepped on my eye once!) but what can I expect during the procedure and after? Will I be miserable? Is valium enough for the procedure? I'm curious!

posted by bodgy to health & fitness (4 answers total)

Well, my mom had glaucoma surgery (the creation of a hole or "bleb" inside her eyelid to drain fluid) and she had very little pain afterwards... mostly her eyes were swollen and a bit dry. They'll probably give you some eyedrops afterwards, including perhaps something (a drop or cream) to moisten them. Sorry I don't know more about corneal surgery specifically.
posted by IndigoRain at 7:11 PM on February 25, 2011

I haven't had it. I've had a bunch of other obnoxious eye surgeries (including The Most Painful One in the Entire Book, scleral buckle with cryopexy post-retinal detachment). I've read about it. It's gonna hurt after the fact-- they're debriding your cornea, basically, same as they debride wounds on burn patients. The cornea is very sensitive, as you well know from your erosions. It's going to complain when it's had all its loose bits scaled off.

While you're there, though, it'll be OK. They'll use topical anesthetic drops to deaden the pain during the procedure. You should try to get and fill your painkiller scrip before you go, or have your lovely assistant (you have one, right? get one) do so while you're getting your procedure done-- you're going to want to get painkillers in before the anesthetic drops wear off. If you are polite and ask nicely, and it's medically appropriate, they may give you an extra shot of the topical for the road.

They may place a special contact lens on your eye as a bandage, or a pressure bandage. If anything happens to that contact lens, call them back immediately. Do the drops they give you religiously. Keep a schedule on your phone or on an index card if you have to. Don't skip any or forget them. Wash your hands before you do the drops, every time. Make all your followup appointments; corneas are touchy and need monitoring while they heal.

Corneal Surgery: Theory, Technique, and and Tissue, page 145 (it's in Google Books if you want it, although my docs always told me not to read up before I went for something), says that the patient should expect "a significant amount of discomfort." It also says that it takes 2-7 days to regrow your corneal epithelium, and that the recovery time is pretty long. Make arrangements with your employer to not be there for a few days.

Mostly, I think you'll be OK, if uncomfortable as fuck for a bit. Just keep the painkillers going in and do the drops every time on time.
posted by fairytale of los angeles at 11:57 PM on February 25, 2011 [1 favorite]

also no offense but omg a DOG stepped on your EYE and here I thought I was a special snowflake because I broke a laptop screen over my head at 35mph oh god.
posted by fairytale of los angeles at 12:00 AM on February 26, 2011

I had a superficial keratectomy last month. I felt nothing during the procedure; my eye was completely numb from a topical anesthetic (no shots required). The whole thing took about ten minutes, and would have been a non-event, but I'm a fainter. About the time the doctor told me that he was 75% done with the debridement, I started to swoon—it made for a lousy finish.

I went home with a patch over my eye and instructions to remove it the following day, at which point I was to begin with two prescriptions for eye drops. I was also given a prescription for tylenol w/codeine.

For some crazy reason, I thought I was going to get away with using ibuprofen for the pain...what was I thinking?? When the topical wore off, I was more than happy to take that codeine, thanks. The smarter thing (as suggested by fairytale, above) would have been to take it as soon I left the doctor's office. I ended up using one tablet every four to six hours for four days. I found that two tabs made me queasy, and one was good enough to keep me drowsy and half-way comfortable. By day five the pain was more tolerable and I was on ibuprofen only, but it was still quite uncomfortable. I think I started to feel human after seven days or so. By then it wasn't so much pain as a feeling of being scratchy. The doctor recommended GenTeal gel eye drops for that.

I'm not working at the moment, so I had the luxury of being able to take as much time for recovery as I felt I needed. That was lucky for me, because I happen to have a very low pain threshold. For four days after the procedure, I was in a recliner with both eyes closed, and a lot of that time, I slept. Trying to look out of my good eye without opening my wounded eye was next to impossible, because when my good eye was open, my bad eye tried to be open. Every time my lid passed over that eye, it stung. I quickly realized that it was not worth the pain. I kept a patch over the eye for a couple more days just to help me keep it closed. Closed felt best. After a week, I was in pretty good shape pain-wise. Vision was blurry until about week five.

Hope this helps.
posted by VioletShalimar at 12:43 PM on February 27, 2011