title: Effect of preoperative counseling on fear from visual sensations during phacoemulsification under topical anesthesia.
abstract: OBJECTIVE
  To determine whether preoperative counseling on possible intraoperative visual perceptions during cataract surgery helps reduce the patients' fear during surgery.
  
  
  METHODS
  Aravind Eye Hospital, Madurai, India.
  
  
  METHODS
  Randomized masked clinical trial.
  
  
  METHODS
  Patients having phacoemulsification under topical anesthesia were randomized to receive additional preoperative counseling or no additional preoperative counseling on potential intraoperative visual perceptions. After surgery, all patients were interviewed about their intraoperative experiences.
  
  
  RESULTS
  Of 851 patients, 558 (65.6%) received additional preoperative counseling and 293 (34.4%) received no additional counseling. A lower proportion of patients in the counseled group were frightened than in the group not counseled for visual sensation (4.5% versus 10.6%, P<.001). Analyzed separately by specific visual sensations, similar results were found for light perception (7/558 [1.3%] versus 13/293 [4.4%], P=.007), colors (P=.001), and movement (P=.020). The mean fear score was significantly lower in the counseled group than in the not-counseled group for light perception (0.03 versus 0.12, P=.002), colors (P=.001), movement (P=.005), and flashes (P=.035). Preoperative counseling was a significant factor affecting fear after accounting for age, sex, operated eye, and duration of surgery (multivariate odds ratio, 4.3; 95% confidence interval, 1.6-11.6; P=.003).
  
  
  CONCLUSIONS
  Preoperative counseling on possible visual sensations during cataract surgery under topical anesthesia significantly reduced the mean fear score and the proportion of patients reporting being frightened.
authors.affiliation: Center of Excellence for Cataract Services, Aravind Eye Hospital, Madurai, India.
authors.forename: Aravind
authors.initials: A
authors.lastname: Haripriya
authors.forename: Colin S H
authors.initials: CS
authors.lastname: Tan
authors.forename: Rengaraj
authors.initials: R
authors.lastname: Venkatesh
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Aravind
authors.forename: Anand
authors.initials: A
authors.lastname: Dev
authors.forename: Kah-Guan
authors.initials: KG
authors.lastname: Au Eong
mesh_terms: D000328:Adult; D000368:Aged; D000772:Anesthesia, Local; D003376:Counseling / Q000379:methods*; D004311:Double-Blind Method; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D018918:Phacoemulsification; D011300:Preoperative Care; D011446:Prospective Studies; D012678:Sensation Disorders / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014785:Vision, Ocular / Q000502:physiology; D014796:Visual Perception / Q000502:physiology