Intraoperative visual experience and preoperative counselling during phacoemulsification under topical anaesthesia

Abstract

Background: Phacoemulsifi cation surgery using topical anaesthesia makes patient experience a multitude of visual sensations. However, it makes cataract surgery safe with the quickest visual recovery. Objective: To fi nd the effect of preoperative counselling about potential intraoperative visual experience during phacoemulsifi cation under topical anaesthesia to alleviate fear in patients having cataract surgery. Methods: This non-randomized and non comparative study was carried out in a tertiary care hospital from February 2015 to April 2015. Forty fi ve adult patients underwent cataract surgery (phacoemulsifi cation with foldable intraocular lens implantation) under topical anaesthesia using Proparacaine hydrochloride 0.5 % eye drops by a single surgeon. All patients received counselling on the potential intraoperative visual experience during phacoemulsifi cation. A structured questionnaire was used to collect data on socio-demographics, pain, intraoperative visual experiences and their fear. Participants were asked if they experienced visual sensations such as light perception, gush of water and movements during surgery. Results: Nineteen (42.2%) of them were men and 26 (57.8%) were women. Sixty nine percent of the patients were above 60 years. All of them reported having experienced visual sensations during surgery, the most common being light perception (100%), movements of instruments or surgeon's hands (91.1%) and gush of water (62.2%). One case (4.4%) felt tolerable pain associated with fear (P=0.000) due to these visual experience. Conclusion: Preoperative counselling about the potential intraoperative visual experience during phacoemulsifi cation under topical anaesthesia alleviates the visual experience fear in patients having cataract surgery.