Intraindividual study of anxiety and pain in sequential cataract surgery

Abstract

Purpose: An understanding of the patient’s anxiety and pain and differences if any between the first and second cataract surgery can help patients, paramedics and surgeons to plan and execute a surgical procedure which is tailor made to the individual patient’s expectations, capabilities and weaknesses and ensure a happy patient and an even happier surgeon. This study was therefore proposed to compare bilateral cataract patient’s evaluation of pain and anxiety between first and second phacoemulsification surgery under topical anaesthesia. Materials and Methods: A prospective observational study was carried out, recruiting 60 patients of bilateral cataract scheduled for sequential phacoemulsification surgery under topical anaesthesia. The patients were assessed for anxiety in the preoperative room and for operative pain in the postoperative room by a numbered Visual Analog Scale (VAS) and modifiedWong-Baker faces scale. Peroperative assessment of surgeon’s comfort and patient satisfaction and comfort were recorded by a questionnaire, administered by a trained investigator. Results: Mean anxiety score was 3.151.21 (MeanSD) for first eye surgery and 1.580.89 for second eye surgery and was statistically significant (p first eye surgery. Mean pain score was 0.730.86 for first and 2.170.90 for second eye surgery and was statistically significant (p significant difference was observed in the surgeon’s grading of operative comfort and satisfaction between the two procedures. Conclusions: Higher visual disability, expectation from surgery and higher psychological stress lead to higher anxiety and lower pain score in first eye surgery, while previous successful surgery and operative experience lead to lower anxiety scores in second surgery. A relaxed mental state with consequent attention to operative process leads to higher pain score during the second surgery. Contrary to popular reasoning, patients undergoing second eye cataract surgery need a more detailed exp