An analysis of pain and anxiety experienced by patients has concluded that those having immediate sequential bilateral cataract surgery (ISBCS) reported significantly decreased anxiety scores before the second surgery.
And it suggested that ISBCS may be a good strategy for more anxious patients who expect to experience increased pain during the second surgery.
The research at Korea University Guro Hospital’s Department of Ophthalmology compared preoperative anxiety and intraoperative pain between the first and second cataract surgeries in patients who underwent ISBCS.
This retrospective study was conducted between 20 June and 20 September, 2023, and involved a total of 170 cataract surgeries, with 130 eyes undergoing ISBCS, and 40 eyes unilateral cataract surgery.
Among the unilateral cataract surgery patients, 13 (7.65%) had previously experienced cataract surgery on the other eye, while 27 (15.89%) had not undergone previous cataract surgery.
In the study, each patient’s anxiety score and pain score were measured at the operation room immediately preceding and immediately following each surgery.
Before starting the surgical draping, patients were asked their anxiety level using the visual analog scale for anxiety (VASA) of between 0 and 10 points, from 0 points for no anxiety to 10 points for overwhelming terror.
After the surgical procedure, the pain score was investigated using the VAS for pain, from 0 points for no pain to 10 points for unbearable pain.
The results showed a significant drop in anxiety between the first and second ISBCS surgeries, but not pain.
The researchers said “it is possible that ISBCS patients might have overestimated the pain score of the first surgery”.
“When we compared anxiety and pain scores from the first ISBCS surgery and the first unilateral surgery, they did not statistically differ,” the researchers said.
“Also, there was no statistical difference in either score between the second ISBCS surgery and the second unilateral surgery.”
They concluded that ISBCS patients reported significantly lower anxiety scores before the second cataract surgery.
One reason could be the shorter time between the surgeries, they said.
After a positive experience during the first cataract surgery, patients feared the second surgery less, they said.
“We suggest that, as the interval between the ISBCS first and second surgeries is short, ISBCS patients have a relatively vivid memory of the previous surgery as the time gap between the two surgeries is not sufficient to induce recollection error.”
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