title: Patients' expectation and experience of visual sensations during phacoemulsification under topical anaesthesia.
abstract: OBJECTIVE
  To describe what patients expect to see and the visual sensations they actually experience during phacoemulsification under topical anaesthesia. We also sought to determine if patients find their intraoperative visual experience frightening and the factors associated with this.
  
  
  METHODS
  Ninety-eight patients who underwent phacoemulsification and intraocular lens implantation under topical anaesthesia were interviewed preoperatively on what they expected to see with their operated eye during surgery and again postoperatively on what they actually saw. No patient received counselling about possible intraoperative visual sensations. A logistic (multivariate) regression model was used for statistical analysis.
  
  
  RESULTS
  Preoperatively, 36 patients (36.7%) expected at least light perception, 38 (38.8%) expected no light perception, and 24 (24.5%) were unsure what to expect. Some patients also expected a variety of different visual sensations. Postoperatively, all patients (100%) reported seeing light intraoperatively and many experienced various other visual sensations. Nineteen patients (19.4%) found their visual experience frightening. The following factors were statistically associated with a frightening visual experience: preoperative anxiety, previous cataract surgery in the fellow eye, experiencing an intraoperative increase in clarity, not seeing movement intraoperatively, and not knowing what to expect.
  
  
  CONCLUSIONS
  The majority of patients in this study either expected that they would see nothing at all during the surgery or were unsure of what to expect. All patients subsequently saw at least some light, and many perceived various other visual sensations that were frightening to nearly one in five patients. Preoperative counselling should inform about possible intraoperative visual experience.
authors.affiliation: The Eye Institute at Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore.
authors.forename: C-L
authors.initials: CL
authors.lastname: Ang
authors.forename: K G
authors.initials: KG
authors.lastname: Au Eong
authors.forename: S S G
authors.initials: SS
authors.lastname: Lee
authors.forename: S P
authors.initials: SP
authors.lastname: Chan
authors.forename: C S H
authors.initials: CS
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D003376:Counseling; D005239:Fear / Q000523:psychology; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D019654:Lens Implantation, Intraocular; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D018918:Phacoemulsification; D011300:Preoperative Care / Q000379:methods; D012307:Risk Factors; D014796:Visual Perception