"Instant vision" compared with postoperative patching: clinical evaluation and patient satisfaction after bilateral cataract surgery.
OBJECTIVE
To compare two methods of postoperative dressing regimen: patching vs "instant vision" without patch.


METHODS
Prospective randomized clinical trial.


METHODS
Sixty consecutive hospitalized, nonambulatory patients with cataract surgery under topical anesthesia on both eyes at different days were enrolled prospectively. In randomized order, one eye was patched for the first 24 hours postoperatively; the other eye was left open without patch to obtain "instant vision." Both eyes received the same anti-inflammatory and antibiotic drop therapy.


RESULTS
Twenty-four hours postoperatively, no significant differences between patching and "instant vision" could be found for corrected and uncorrected visual acuity, corneal epithelial defects, conjunctival inflammation, anterior chamber flare, and intraocular pressure (P > .05). During the first 24 hours postoperatively, all tear film parameters were significantly worse in the "instant vision" eyes (P < .001), indicating a transient tear film instability. During the first four hours after cataract surgery, pain scores in the "instant vision" eyes were significantly higher than in the patched eyes (P < .001). Eight hours postoperatively and later, there were no significant differences in any pain scores (P > .05). After experiencing both methods, 27% of the patients subjectively rated the two methods as equivalent; 8% of the patients preferred "instant vision." Despite of the benefits of immediately improved orientation, 65% of the tested patients preferred patching to "instant vision" because of lower pain and foreign body sensations and psychologic arguments.


CONCLUSIONS
The clinical examinations showed that both methods were equally safe for postoperative therapy. However, further efforts have to be made to increase the patients' comfort with "instant vision" in the first hours after cataract surgery.
Stifter
Eva
E
Department of Ophthalmology, Medical University of Vienna, Austria.
Menapace
Rupert
R
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D003316:Corneal Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009779:Occlusive Dressings; D009799:Ocular Physiological Phenomena; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies; D013666:Tears / Q000378:metabolism