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Intraindividual study of anxiety and pain in sequential cataract surgery

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Original Article

Author Details : Suuny Bhatia, Ziya Siddiqui*, Sableen Ahmad Khan, R Maheshwari, Ali Jafer Abedi

Volume : 5, Issue : 4, Year : 2019

Article Page : 585-588

https://doi.org/10.18231/j.ijceo.2019.133

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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 <0> 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 <0> 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 explanation of the
operative procedure, anaesthesia techniques and outcomes.

Keywords: Anxiety, Cataract, Phacoemulsification, Pain, Topical anesthesia.

How to cite : Bhatia S, Siddiqui Z, Khan S A, Maheshwari R, Abedi A J, Intraindividual study of anxiety and pain in sequential cataract surgery. Indian J Clin Exp Ophthalmol 2019;5(4):585-588

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