Psychiatric profile of retinal detachment surgery under regional block

Abstract

Purpose:The aim of this study was to investigate whether Saudi patients undergoing retinal surgery are more prone to perioperative anxiety and/or depression, to determine the relation between pre and postoperative emotional upset and also, to find the relation between severity of visual impairment and psychological dysfunction.Methods:Forty patients with retinal detachment (RD) undergoing Pars Plana Vitrecctomy were enrolled in this descriptive study. Regional block was performed using peribulbar technique in order to avoid confounding psychological effects of general anesthesia. The patients were tested for anxiety and depression using Hamilton Anxiety Rating Scale (HARS) and Beck Depression Inventory (BDI) one day before surgery and before discharge.Results:Psychological disturbance reported only by 17.5 percent of the studied patients. Preoperatively 71 percent of them showed mild to moderate anxiety. After the procedure, 80 percent of anxious patients maintained or experienced decrease level of anxiety. In addition to anxiety, 20 percent of anxious patient developed postoperative mild depression. 14 percent of the psychologically disturbed patients had moderate depression before surgery which became milder after it. Another 14 percent showed severe anxiety and moderate depression only postoperatively. Severe visual impairment was reported by 86 percent of psychological disturbed patients.Conclusion:Saudi patients with RD undergoing retinal procedures infrequently suffered anxiety and/or depression. Preoperative psychological disturbances were a good predictor of postoperative emotional upset. Perioperative psychological disturbances were related positively to the severity of visual impairment.