Perceived Pain during Cataract Surgery with Topical Anesthesia: A Comparison between First-Eye and Second-Eye Surgery

Abstract

Purpose. To compare pain scores between first-eye and second-eye cataract surgery and to determine the affecting factors. Methods. 106 first-eye and 53 second-eye cataract surgery patients (mean age: 67 ± 13 and 69 ± 10 years, resp.) were enrolled. The patients completed simplified State-Trait Anxiety Inventory and visual analog scale (VAS) for anxiety questionnaires before surgery, and VAS for pain and Wong-Baker Faces Pain Rating Scale questionnaires after surgery. Blood pressure (BP) and heart rate (HR) were recorded perioperatively. Results. A greater proportion of patients who underwent second-eye surgery reported intraoperative pain compared with first-eye surgery patients (85% versus 35%, P < 0.001). The pain scores were higher in second-eye surgery, while the VAS anxiety score was lower in second-eye surgery. Moreover, 31 patients reported greater pain during second-eye surgery than their first one, with higher pain scores than other 22 patients (P = 0.032 and 0.003, resp.). The VAS pain score of these 31 patients was positively correlated with the differences between the intraoperative and postoperative diastolic BP, mean arterial pressure, and HR. Conclusions. Cataract patients were likely to have more pain during second-eye surgery, which may be related to lower preoperative anxiety. Monitoring perioperative BP and HR may help to identify patients with intraoperative pain.

<p>Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures</p>

“…We found a subtle, but statistically significant increase in pain in patients undergoing second eye surgery. This has previously been reported for various types of ophthalmic anesthesia [22][23][24][25][26][27] and is likely to be related to the lower preoperative anxiety prior to second eye surgery, 25,26 or amnestic effect of intravenous sedation. 26 In this study, sub-Tenon's anesthesia achieved great results with complete akinesia and we highlighted some advantages of this technique over cataract/refractive lens exchange performed with topical anesthesia only.…”

Molecular Inflammation in the Contralateral Eye After Cataract Surgery in the First Eye

“…36 Monocyte chemoattractant protein 1 levels in the aqueous humor of patients undergoing second-eye cataract surgery were also found positively correlated with the extent of pain in the same eye according to our previous study (Spearman q ¼ 0.539, P < 0.001). 37 Monocyte chemoattractant protein 1 may also be a biomarker of sympathetic eye condition. One of the most well-known sympathetic eye conditions is sympathetic ophthalmia, a type of bilateral diffuse granulomatous panuveitis that develops after surgical or penetrating trauma to one eye, followed by the onset of uveitis in the contralateral eye.…”

Assessment of pre and postoperative psychiatric comorbidity among patients scheduled for elective cataract surgery in Lagos, Nigeria

“…Preoperative and postoperative comorbid psychiatric disorders have been documented to be globally common among individuals scheduled for elective surgical interventions (1)(2)(3). Comorbid psychiatric disorders in surgical patients were also reported to be challenging especially in the psychiatric management of these patients (1)(2)(3)(4).…”

“…Preoperative and postoperative comorbid psychiatric disorders have been documented to be globally common among individuals scheduled for elective surgical interventions (1)(2)(3). Comorbid psychiatric disorders in surgical patients were also reported to be challenging especially in the psychiatric management of these patients (1)(2)(3)(4). The relationship between individuals with cataract who were scheduled for surgery and the presence of comorbid psychiatric disorders were postulated to be due to agony of anaesthesia, fear of becoming blind from surgery, blood transfusion, and the persistent worry that nobody will take care of their family in case death from surgery (5)(6).…”