[Phantom pain after eye enucleation].

BACKGROUND

Phantom pain is a well known and extensively documented complication after limb amputation. Nearly all surgical disciplines have to deal with phantom symptoms related to different anatomical regions and organs but limited data is available about phantom eye pain (PEP) after enucleation. Only one pilot study is present in literature. It was the aim of this study to analyze a group of patients with a standardized surgical procedure of enucleation concerning the incidence of PEP and its relation to further preoperative and postoperative data.

METHODS

A standardized questionnaire was sent to all enucleation patients with primary orbital implant performed between 1/1/1986 and 12/31/1995 at Münster University. Data of 94 patients could be analyzed with regard to PEP, perioperative pain symptoms and further ophthalmological and surgical data.

RESULTS

24 of 94 patients reported PEP after enucleation. The frequency of PEP was less than once per month in the majority of patients (71%). 2 of 24 patients suffered from PEP on more than 4 days/month. Perioperative pain symptoms (ocular pain [OP], preoperative and postoperative headache) were reported with a higher proportion (each p<0.0025) in patients with PEP compared to those not affected by PEP. All patients with a preoperative history of OP longer than 5 years and 75% of patients with OP longer than 12 months of pre-enucleation OP were affected by PEP.

CONCLUSIONS

Phantom eye pain is present in nearly 1/4 of patients after enucleation and is significantly related to other perioperative pain symptoms.