title: Prospective randomized double-masked trial to evaluate perioperative pain profile in different stages of simultaneous bilateral LASIK.
abstract: OBJECTIVE
  To evaluate the perioperative pain profile in simultaneous bilateral LASIK.
  
  
  METHODS
  Fifty consecutive Chinese patients undergoing simultaneous bilateral LASIK were randomly allocated to have either the right or left eye operated first. The pain scores for each eye at speculum placement, microkeratome cut, laser ablation, and at 15, 30, and 45 minutes after the procedure were recorded. In addition, an overall score for the whole operation was evaluated immediately after the procedure for each eye. Comparisons between eyes and among different stages of the procedures were analyzed.
  
  
  RESULTS
  The second eye was significantly more painful than the first eye at the stage of speculum placement and microkeratome pass (P < 0.001). Laser ablation was the least painful stage for both eyes. There were no statistical differences in pain scores for the postoperative period.
  
  
  CONCLUSIONS
  Higher pain scores were associated with the stages involving eyelid manipulation. In patients with small palpebral fissures where stretching of the eyelid structures are anticipated, supplementary anesthesia for the lid region should be considered when required.
authors.affiliation: Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, University Eye Center, Hong Kong Eye Hospital, Hong Kong, China.
authors.forename: Arthur C K
authors.initials: AC
authors.lastname: Cheng
authors.forename: Alvin L
authors.initials: AL
authors.lastname: Young
authors.forename: Ricky W K
authors.initials: RW
authors.lastname: Law
authors.forename: Dennis S C
authors.initials: DS
authors.lastname: Lam
mesh_terms: D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D020731:Keratomileusis, Laser In Situ; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000188:drug therapy; D011430:Propoxycaine / Q000008:administration & dosage; D011446:Prospective Studies; D054140:Refractive Surgical Procedures
chemical_list: D000779:Anesthetics, Local; C005717:proxymetacaine; D011430:Propoxycaine