Patient anxiety and pain levels increase during second cataract surgery

A rise in pain during the second cataract extraction was linked to lower preoperative anxiety and amnestic effects of intravenous sedation, according to a study published in the Journal of Cataract and Refractive Surgery.

Dr Roxana Ursea et al., Department of Ophthalmology and Vision, University of Arizona, Tucson, Arizona, USA, conducted a cohort study on 65 patients undergoing bilateral sequential clear corneal extraction. Phacoemulsification was used with topical monitored anaesthesia. Patients excluded from the results were those with baseline eye pain, poor comprehension and complicated cataract extraction. Four brief surveys were completed perioperatively including: the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Scale (STAI). Postoperatively, two visual analogue scale pain surveys were completed with scores between 0 and 10.

Out of the patients, 26 had higher visual analogue scale pain scores during the second cataract operation. The average pain score for the first extraction was 0 on the scale and for the second extraction was 1. Postoperatively, the pain scores were very similar after 1 day. APAIS and STAI anxiety scores lowered between surgeries.

The pain rating recorded in the second cataract extraction was associated with decrease in patient anxiety and amnesic effects, of intravenous sedation.