Effectiveness of ultrasound-guided pulsed radiofrequency of the stellate ganglion for pain management in painful blind eye: a prospective case series

Painful blind eye (PBE) is a debilitating condition with limited and often unsatisfactory treatment options. This study describes our clinical experience with ultrasound-guided pulsed radiofrequency (PRF) of the stellate ganglion for pain management in PBE patients. This prospective case series included 20 consecutive PBE patients with chronic pain unresponsive to initial medical management. All underwent ultrasound-guided PRF of the stellate ganglion after a positive diagnostic block. Pain severity was assessed using the Numerical Rating Scale (NRS) at baseline and at multiple follow-up points for up to one year. The primary outcome was the change in NRS score. Secondary outcomes included analgesic use and the need for further interventions. The median NRS score significantly decreased from a baseline of 8.66 (IQR: 8.32–9.11) to 2.07 (IQR: 1.46–2.70) at one year (P < 0.0001). The need for analgesic medications was significantly reduced (P < 0.0001), and no patient required subsequent retrobulbar injections or surgical enucleation/evisceration. No major adverse events were reported. In our experience, ultrasound-guided PRF of the stellate ganglion was a promising and well-tolerated, globe-sparing treatment for refractory pain in PBE. While these preliminary findings are encouraging, this was a small, uncontrolled case series. Therefore, the effectiveness of this technique requires confirmation in larger, controlled trials before it can be widely recommended.