Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye

Objective To investigate quantitative changes in iris blood flow after first-eye and second-eye cataract surgeries, and their correlation with increased pain in the second eye.Methods and analysis In this prospective study, 88 eyes of 44 participants who underwent uneventful cataract surgery were fo...

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Main Authors: Yi Lu, Xiangjia Zhu, Wenwen He, Jiao Qi, Yu Du, Jiaqi Meng, Jitong Zhou, Kaiwen Cheng, Yuxi Chen, Yunqian Yao
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Open Ophthalmology
Online Access:https://bmjophth.bmj.com/content/10/1/e002162.full
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author Yi Lu
Xiangjia Zhu
Wenwen He
Jiao Qi
Yu Du
Jiaqi Meng
Jitong Zhou
Kaiwen Cheng
Yuxi Chen
Yunqian Yao
author_facet Yi Lu
Xiangjia Zhu
Wenwen He
Jiao Qi
Yu Du
Jiaqi Meng
Jitong Zhou
Kaiwen Cheng
Yuxi Chen
Yunqian Yao
author_sort Yi Lu
collection DOAJ
description Objective To investigate quantitative changes in iris blood flow after first-eye and second-eye cataract surgeries, and their correlation with increased pain in the second eye.Methods and analysis In this prospective study, 88 eyes of 44 participants who underwent uneventful cataract surgery were followed up at enrolment, 1 day before, and 1 day, 1 week and 1 month after each eye surgery. Iris blood flow was quantified by a swept-source optical coherence tomography angiography and intraoperative pain was evaluated. Participants were divided into three groups according to time intervals between two eye surgeries: ≥1 to <2 weeks (short interval), ≥2 to ≤4 weeks (medium interval) and greater than 4 weeks (long interval).Results The second eye experienced two significant increases in iris blood flow following cataract surgery: one after the first eye and the other after its own, with the latter being significantly higher than the increase observed in the operated eye after the first surgery (p<0.05). Additionally, the second eye showed higher iris blood flow density in the short interval group compared with the long and medium at specific time points (p<0.05). The bilateral pain index difference positively correlated with second eye iris blood flow density (p<0.05) and was significantly greater in the short interval group than the long interval group (p<0.05).Conclusions Iris blood flow increased in the second-operated eye post surgery compared with the first eye, which may correlate to second-eye pain. However, due to the variability in individual pain perception, a larger sample size is needed to prospectively validate our findings to improve their generalisability.Trial registration number NCT02182921.
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spelling doaj-art-c27cb84c4c384d5f91f67929651a72002025-08-21T02:35:15ZengBMJ Publishing GroupBMJ Open Ophthalmology2397-32692025-08-0110110.1136/bmjophth-2025-002162Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eyeYi Lu0Xiangjia Zhu1Wenwen He2Jiao Qi3Yu Du4Jiaqi Meng5Jitong Zhou6Kaiwen Cheng7Yuxi Chen8Yunqian Yao92 NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China3 Key Laboratory of Myopia, Chinese Academy of Medical Science, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China4 Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China2 NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, China1 Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai, ChinaObjective To investigate quantitative changes in iris blood flow after first-eye and second-eye cataract surgeries, and their correlation with increased pain in the second eye.Methods and analysis In this prospective study, 88 eyes of 44 participants who underwent uneventful cataract surgery were followed up at enrolment, 1 day before, and 1 day, 1 week and 1 month after each eye surgery. Iris blood flow was quantified by a swept-source optical coherence tomography angiography and intraoperative pain was evaluated. Participants were divided into three groups according to time intervals between two eye surgeries: ≥1 to <2 weeks (short interval), ≥2 to ≤4 weeks (medium interval) and greater than 4 weeks (long interval).Results The second eye experienced two significant increases in iris blood flow following cataract surgery: one after the first eye and the other after its own, with the latter being significantly higher than the increase observed in the operated eye after the first surgery (p<0.05). Additionally, the second eye showed higher iris blood flow density in the short interval group compared with the long and medium at specific time points (p<0.05). The bilateral pain index difference positively correlated with second eye iris blood flow density (p<0.05) and was significantly greater in the short interval group than the long interval group (p<0.05).Conclusions Iris blood flow increased in the second-operated eye post surgery compared with the first eye, which may correlate to second-eye pain. However, due to the variability in individual pain perception, a larger sample size is needed to prospectively validate our findings to improve their generalisability.Trial registration number NCT02182921.https://bmjophth.bmj.com/content/10/1/e002162.full
spellingShingle Yi Lu
Xiangjia Zhu
Wenwen He
Jiao Qi
Yu Du
Jiaqi Meng
Jitong Zhou
Kaiwen Cheng
Yuxi Chen
Yunqian Yao
Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
BMJ Open Ophthalmology
title Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
title_full Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
title_fullStr Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
title_full_unstemmed Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
title_short Comparative analysis of iris blood flow after first-eye and second-eye cataract surgeries: insights into increased pain perception in the second eye
title_sort comparative analysis of iris blood flow after first eye and second eye cataract surgeries insights into increased pain perception in the second eye
url https://bmjophth.bmj.com/content/10/1/e002162.full
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