title: Patient perceptions of second eye clear corneal cataract surgery using assisted topical anaesthesia.
abstract: OBJECTIVE
  To assess patient recall of intraoperative pain, anxiety, fear, and sensory (visual and auditory) perceptions during second eye clear corneal cataract surgery using assisted topical anaesthesia (ATA), in comparison with first eye cataract surgery using the same technique.
  
  
  METHODS
  This prospective, consecutive, observational study was conducted in a free-standing dedicated ophthalmic day surgery centre. A voluntary questionnaire was distributed to 129 consecutive patients who underwent clear corneal cataract surgery using ATA. Two patients had to be converted to block anaesthesia, and were excluded. Patients were asked to rate intraoperative pain, anxiety, and fear using a visual analogue scale (VAS), and recollection of intraoperative visual and auditory perceptions. Results were analysed using the Mann-Whitney U and Spearman correlation tests.
  
  
  RESULTS
  There were 70/127 (55%) patients undergoing first eye cataract surgery and 57/127 (45%) undergoing second eye surgery. There was no significant difference in mean pain, anxiety, and fear scores between those undergoing the second eye operation compared with those undergoing their first eye operation. Similarly, there was no significant difference in sensory perceptions between the two cohorts. Overall, there was a small but significant positive correlation between recall of visual and auditory perceptions and combined pain, fear, and anxiety scores (r=0.33, P=0.0002).
  
  
  CONCLUSIONS
  There was no significant difference in levels of intraoperative pain, anxiety, fear, and sensory perceptions experienced by patients between the first eye and second eye surgeries. We recommend that preoperative counselling for a patient's second eye be as comprehensive as for the first eye surgery.
authors.affiliation: Department of Ophthalmology, Prince of Wales Hospital, Randwick, Sydney, Australia.
authors.forename: N S
authors.initials: NS
authors.lastname: Sharma
authors.forename: J-L
authors.initials: JL
authors.lastname: Ooi
authors.forename: E C
authors.initials: EC
authors.lastname: Figueira
authors.forename: M L
authors.initials: ML
authors.lastname: Rosenberg
authors.forename: K
authors.initials: K
authors.lastname: Masselos
authors.forename: D P
authors.initials: DP
authors.lastname: Papalkar
authors.forename: N
authors.initials: N
authors.lastname: Paramanathan
authors.forename: I C
authors.initials: IC
authors.lastname: Francis
authors.forename: S L
authors.initials: SL
authors.lastname: Alexander
authors.forename: N I
authors.initials: NI
authors.lastname: Ferch
mesh_terms: D000556:Ambulatory Surgical Procedures; D000772:Anesthesia, Local; D001007:Anxiety; D001307:Auditory Perception; D005239:Fear; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011939:Mental Recall; D010147:Pain Measurement; D018918:Phacoemulsification; D011446:Prospective Studies; D014796:Visual Perception