A comparative study of pain perception in patients undergoing double cataract surgery

Abstract

Objective To evaluate and compare the pain perception of cataract patients who underwent cataract surgery under topical anesthesia in both eyes during the first and second operations. Methods From October 2016 to October 2017, 73 cases who underwent binocular cataract surgery in the First Affiliated Hospital of Hunan University of Chinese Medicine were studied. Among them, there were 32 males and 41 females, with an average age of (64±8) years. All patients underwent continuous cataract surgery in both eyes. All operations were performed through transparent corneal incision with phacoemulsification and intraocular lens implantation, and the operation was performed under topical anesthesia with anesthesia monitoring. For cataract surgery in each eye, patients must complete two short scales, i. e. visual analogue score is used to score the degree of pain twice (range is 0-10 points). The degree of pain and the difference between binocular pain were the main criteria for evaluation. The data of cataract surgery score, degree grading, anesthesia dosage and operation duration were tested by K-S method. When the data were in normal distribution, t-test was used for comparisons between groups. Otherwise, Wilcoxon sign rank test was used for comparisons, and cases andpercentages were used for descriptions of sex and history of cataract. Chi-square test was used for comparisons. Results Forty-one cases (56%) had higher visual analogue score for the pain degree of cataract surgery in the second eye. The median immediate pain scores of the first eye and the second eye were 0 (range 0-6) and 1 (range 0-9), respectively. The difference was significant (z=3.48, P 0.05). Among all the cases, 41 cases scored higher on the pain degree of the second eye operation. Compared with the other 32 cases, the difference of pain recall between the two groups was statistically significant (χ2=31.01, P<0.05). Conclusion Although the pain of cataract surgery under topical anesthesia with anesthesia monitoring is very light, the pain perception of the second eye surgery is significantly increased compared with that of the first eye surgery. This may be closely related to preoperative anxiety, or may be related to intraoperative amnesia of intravenous sedatives. The data in this study can help to explain a series of common clinical observations after cataract surgery, and can be applied to the study of perioperative management of cataract. Key words: Pain Perception; Binocular cataract surgery; perioperative management