Intraoperative visual experience and preoperative counselling during phacoemulsification under topical anaesthesia

Background: Phacoemulsification surgery using topical anesthesia makes patient experience a multitude of visual sensations. However, it makes cataract surgery safe with the quickest visual recovery. Objective: To find the effect of preoperative counseling about potential intraoperative visual experience during phacoemulsification under topical anesthesia 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 five adult patients underwent cataract surgery (phacoemulsification with foldable intraocular lens implantation) under topical anesthesia using Proparacaine hydrochloride 0.5 % eye drops by a single surgeon. All patients received counseling on the potential intraoperative visual experience during phacoemulsification. 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 counseling about the potential intraoperative visual experience during phacoemulsifiaction under topical anesthesia alleviates the visual experience fear in patients having cataract surgery. Journal of Kathmandu Medical College , Vol. 4, No. 2, Issue 12, Apr.-Jun., 2015, Page: 45-49