title: Pain during second eye cataract surgery under topical anesthesia: an intraindividual study.
abstract: BACKGROUND
  Aim of the study was to investigate: 1) if second eye cataract surgery under topical anesthesia is more painful than surgery on the first eye, 2) if pain experienced during the procedure on the first eye may predict the pain of the second procedure, and 3) if patients' cooperation is different between the first and the second eye procedure.
  
  
  METHODS
  Seventy-three consecutive patients undergoing bilateral non-simultaneous cataract surgery were prospectively included in the study. Surgical technique was sutureless clear corneal phacoemulsification under topical anesthesia. Immediately after surgery every patient graded the pain experienced using a visual analogue scale (VAS) from 0 (no pain) to 10 (unbearable pain). At the end of each procedure the surgeon graded patients' cooperation using a 4-point scale.
  
  
  RESULTS
  Mean VAS score was 2.35 (SD 2.63) for the first eye and 2.89 (SD 2.93) for the second eye. Such a difference was not statistically significant (p = 0.1777, Wilcoxon test). The correlation between the VAS score of the first and that of the second procedure was statistically significant (r = 0.5514, p < 0.0001, Spearman rank correlation). Patients' cooperation was 2.64 (SD 0.63) during the first procedure and 2.52 (SD 0.79) during the second procedure; this difference was not statistically significant (p = 0.1769, Wilcoxon matched-pairs signed-ranks test).
  
  
  CONCLUSIONS
  After uneventful cataract surgery under topical anesthesia, pain experienced and cooperation did not differ between first and second eye procedures. A correlation was found between pain scores of the first and the second eye procedures.
authors.affiliation: Divisione Oculistica, Ospedale San Pietro-Fatebenefratelli, Via Cassia 600, 00189, Rome, Italy. eyedoc.bardocci@gmail.com
authors.forename: Antonio
authors.initials: A
authors.lastname: Bardocci
authors.forename: Francesco
authors.initials: F
authors.lastname: Ciucci
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lofoco
authors.forename: Serenella
authors.initials: S
authors.lastname: Perdicaro
authors.forename: Andrea
authors.initials: A
authors.lastname: Lischetti
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007432:Intraoperative Period; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D010147:Pain Measurement; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local