Ziya Siddiqui1, Sunny Bhatia2, Ahmad Abdullah3, Yasir Alvi4
With the advancement in anaesthetic measures, a safe and effective alternative
to peribulbar and retrobulbar anaesthesia for phacoemulsification is provided by
topical anaesthesia.1 (Fichman, 1996). Studies highlighting varied pain experiences
have been published with some reporting higher pain in second eye surgery,2,3
(Ursea et al. 2011; Tan et al. 2011) while others did not.4,5 (Bardocci, 2011; Hari-
Kovacs, 2012). So, we conducted this study to assess and compare pain
experienced by patients subjectively as well as objectively in first and subsequent
eye following topical phacoemulsification cataract surgery.
METHODS
A prospective observational clinical study was done for a duration of two years at
Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU Aligarh. Study
groups consisted of patients having bilateral cataract, to be operated in both eyes
undergoing topical phacoemulsification and placement of an intraocular lens within
one-year interval. Subjective as well as objective assessment of postoperative pain
was done in the recovery room.
RESULTS
A total of 60 patients were included in the study with 51 (85 %) patients having
higher pain score for second eye surgery as compared to first eye surgery, which
was also significant while comparing their mean pain score (0.73 ??? 0.86 vs 2.17 ???
0.91). Systolic and diastolic blood pressure as well as mean arterial pressure (MAP)
were higher in first eye surgery as compared to second eye surgery.
CONCLUSIONS
In our comparative study, we observed higher pain in second eye surgery. As this
subjective assessment of higher pain was not supplemented by objective
assessment, we concluded that it may be due to more apprehension and
uneasiness because of previous surgery. Patients going for second eye surgery
should be prior consulted as well as managed properly.
