Factors affecting patient cooperation and level of pain perception during phacoemulsification in topical and intracameral anesthesia.

PURPOSE To evaluate selected factors that may influence pain perception and patient cooperation with the surgeon during phacoemulsification performed under topical and intracameral anesthesia. METHODS A total of 203 consecutive patients who had uncomplicated cataract phacoemulsification with foldable intraocular lens implantation through clear corneal 2.8 mm temporal incision under topical anesthesia were enrolled into the study. The factors assessed included gender, age, level of education, professional activity, place of residence, pain sensitivity declared preoperatively, patient mood before operation, preoperative visual acuity, and whether it was the patient's first or second cataract surgery. The correlation between postoperatively declared level of pain perception and cooperation with the surgeon was also evaluated. For statistical analysis, gamma correlation coefficient test was used. RESULTS The strongest correlation was found between gender and cooperation and level of perceived pain. The weakest dependencies were noticed between the level of education and these parameters. Women, patients who were professionally active, and patients who were in a better mood before the operation were more cooperative. A strong correlation was found between patient pain perception and cooperation. CONCLUSIONS Pain perception was positively influenced by female gender, rural place of residence, younger age of patient, and lower preoperative visual acuity. Cooperation with the surgeon was positively influenced by female gender, professional activity, patient good mood before operation, and no pain perception during surgery. There was no correlation between level of education, preoperatively declared pain sensitivity, sequence of operation, and estimated parameters.

[1]  Y. Akar,et al.  Phacoemulsification with topical anesthesia: Resident experience , 2006, Journal of cataract and refractive surgery.

[2]  Sagun J Pendse,et al.  Choosing anesthesia for cataract surgery. , 2006, Ophthalmology clinics of North America.

[3]  T. Lai,et al.  Effect of application duration of 2% lidocaine jelly on aqueous lidocaine concentration for topical anesthesia in cataract surgery , 2006, Graefe's Archive for Clinical and Experimental Ophthalmology.

[4]  K. Au Eong,et al.  Visual experience during phacoemulsification under topical anaesthesia: a nationwide survey of Singapore ophthalmologists , 2005, Clinical & experimental ophthalmology.

[5]  C. Cagini,et al.  Limbal anaesthesia versus topical anaesthesia for clear corneal phacoemulsification. , 2005, Acta ophthalmologica Scandinavica.

[6]  A. A. Velasco e Cruz,et al.  Pain induced by phacoemulsification without sedation using topical or peribulbar anesthesia , 2005, Journal of cataract and refractive surgery.

[7]  D. Lam,et al.  Visual sensation during phacoemulsification and intraocular lens implantation using topical and regional anesthesia , 2004, Journal of cataract and refractive surgery.

[8]  J. Jonas,et al.  Topical versus peribulbar anaesthesia for cataract surgery. , 2003, Acta ophthalmologica Scandinavica.

[9]  V. Yaylalı,et al.  Subjective Visual Experience and Pain Level during Phacoemulsification and Intraocular Lens Implantation under Topical Anesthesia , 2003, Ophthalmologica.

[10]  L. Wilkens,et al.  Pain, photophobia, and retinal and optic nerve function after phacoemulsification with intracameral lidocaine. , 2001, Ophthalmology.

[11]  A. Agarwal,et al.  No‐anesthesia clear corneal phacoemulsification versus topical and topical plus intracameral anesthesia: Randomized clinical trial , 2001, Journal of cataract and refractive surgery.

[12]  T. Fulcher,et al.  Patient pain during different stages of phacoemulsification using topical anesthesia , 2001, Journal of cataract and refractive surgery.

[13]  T. Lim,et al.  Subjective visual experience during phacoemulsification and intraocular lens implantation using retrobulbar anesthesia , 2000, Journal of cataract and refractive surgery.

[14]  A. Lim,et al.  Subjective visual experience during extracapsular cataract extraction and intraocular lens implantation under retrobulbar anaesthesia , 1999, Eye.

[15]  R. Johnston,et al.  Topical versus peribulbar anesthesia, without sedation, for clear corneal phacoemulsification , 1998, Journal of cataract and refractive surgery.

[16]  John H. Shammas,et al.  Topical and subconjunctival anesthesia for phacoemulsification: Prospective study , 1997, Journal of cataract and refractive surgery.

[17]  K. Setälä,et al.  Visual evoked potentials after retrobulbar or periocular anaesthesia. , 1992, The British journal of ophthalmology.

[18]  R. Redmond,et al.  Extracapsular cataract extraction under local anaesthesia without retrobulbar injection. , 1990, The British journal of ophthalmology.