PURPOSE To describe a patient with chronic periocular pain after bilateral photorefractive keratectomy (PRK) and ocular neuralgia that was controlled with regular orbital steroid and anesthetic injections. METHODS Case report. RESULTS A 21-year-old man presented 3 months following bilateral PRK surgery in severe bilateral orbital pain. Previous treatments included topical (artificial tears, corticosteroids, and nonsteroidal anti-inflammatory drugs [NSAIDs) and oral (NSAIDs, opioids, and pregabalin) therapies with minimal pain relief. A bilateral orbital triamcinolone acetonide 40 mg/cc and 0.25% bupivacaine injection was done after a successful, diagnostic unilateral 0.25% bupivacaine injection. Following bilateral bupivacaine and triamcinolone acetonide injections, pain intensity improved from 7 of 9 to 1 of 3 out of 10. Repeat injections have been regularly performed over the past 3 years, allowing the patient to experience improved symptoms lasting from 4 to 9 months. CONCLUSIONS In this case, orbital nerve blocks provided relief and may be considered as a potential treatment for orbital neuralgia after refractive surgery. [J Refract Surg. 2019;35(8):534-537.].

中文翻译：

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双侧眼眶类固醇和麻醉剂注射治疗屈光手术后的眼神经痛。

目的描述一例经定期眼眶类固醇和麻醉剂注射控制的双侧屈光性角膜切除术（PRK）和眼神经痛后患有慢性眼周疼痛的患者。方法病例报告。结果一名21岁男子在双侧PRK手术后3个月出现严重双侧眼眶疼痛。先前的治疗方法包括局部（人工泪液，皮质类固醇和非甾体抗炎药[NSAIDs]）以及口服（NSAIDs，阿片类药物和普瑞巴林）疗法，其缓解疼痛的作用很小。成功诊断性单侧0.25％布比卡因注射成功后，进行了双侧眼眶曲安奈德丙酮40 mg / cc和0.25％布比卡因注射。注射双侧布比卡因和丙酮酸曲安奈德后，疼痛强度从9的7提高到10的3改善。在过去的3年中，定期进行重复注射，使患者的症状改善持续4到9个月。结论在这种情况下，眼眶神经阻滞提供了缓解，并且可以被认为是屈光手术后眼眶神经痛的潜在治疗方法。[J Refract Surg。2019; 35（8）：534-537。]。