ArticleFrontiers in medicine2025
Systemic inflammatory and oxidative stress biomarkers as predictors of pain in sequential bilateral phacoemulsification for age-related cataract.
Article in Frontiers in medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Comorbidity Associations with Ocular Pain after Cataract Surgery: Overall and Sex-Stratified Analysis.AJO international · 2026Article
- Association between systemic immune-inflammation index and postoperative optical quality in the early recovery phase after cataract surgery: a retrospective study.Frontiers in medicine · 2026Article
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6 authors.
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Abstract
Background: Second-eye cataract surgery is frequently associated with enhanced pain perception compared to first-eye procedures, yet the underlying pathophysiological mechanisms remain incompletely understood. This study investigated whether systemic inflammatory biomarkers and oxidative stress indicators could predict and explain the differential pain experience in sequential bilateral phacoemulsification for age-related cataract. Methods: In this prospective, single-blinded case-control study, we enrolled 80 patients with age-related cataract undergoing sequential bilateral phacoemulsification. Patients underwent first-eye surgery followed by second-eye surgery within a median interval of 2.5 months (range: 1-3 months). Matching was performed using propensity score matching based on age (±2 years), gender, diabetes status (HbA1c levels), and hypertension status (blood pressure measurements). Inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), and the oxidative stress marker superoxide dismutase (SOD), were analyzed in preoperative blood samples. Postoperative pain was evaluated 24 h after surgery using the visual analog scale (VAS). A novel cataract pain prediction model, along with correlation analysis and receiver operating characteristic (ROC) curves, was developed to assess the diagnostic and predictive value of these biomarkers. Results: The second-eye surgery group demonstrated significantly elevated levels of systemic inflammatory markers (NLR, MLR, CRP, IL-6, and IL-8) and oxidative stress indicator (SOD) compared to first-eye patients (all Conclusion: This study demonstrates a significant association between increased systemic inflammatory biomarkers, oxidative stress indicators, and heightened pain perception in second-eye cataract surgery. Our findings provide valuable insights into the pathophysiological mechanisms underlying the second-eye phenomenon and offer potential clinical biomarkers for preoperative pain risk stratification. Implementation of these biomarkers could guide personalized analgesic strategies and improve patient care in sequential bilateral cataract surgery.
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