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Visual perception during phacoemulsification cataract surgery under subtenons anaesthesia.

S S Wickremasinghe1, P G Tranos, N Sinclair

  • 1Department of Ophthalmology, Royal Free Hospital, Pond Street, London NW3 2QG, UK. sanjeewa_w@hotmail.com

Eye (London, England)
|June 13, 2003
PubMed
Summary

Patients undergoing cataract surgery under subtenons anesthesia reported varied visual experiences, with color perception and low anesthetic volume linked to frightening sensations. Preoperative counseling is essential to manage patient anxiety during the procedure.

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Area of Science:

  • Ophthalmology
  • Anesthesiology

Background:

  • Cataract surgery, specifically phacoemulsification with intraocular lens implantation, is commonly performed under regional anesthesia.
  • Understanding the subjective visual experiences of patients during this procedure is crucial for improving patient care and reducing anxiety.

Purpose of the Study:

  • To document the subjective visual experiences of patients during phacoemulsification and intraocular lens implantation under subtenons anesthesia.
  • To identify factors associated with frightening visual experiences during cataract surgery.

Main Methods:

  • A prospective, non-randomized cohort study involving 104 patients undergoing routine phacoemulsification and intraocular lens implantation.
  • Postoperative questionnaires were used to collect data on visual experiences, with statistical analysis including chi-squared and Fisher's exact tests.

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Main Results:

  • 87.5% of patients reported seeing light, with 9.6% experiencing pain. Younger patients showed higher rates of photophobia.
  • 56.7% saw colored lights, and 13.5% found the visual experience frightening, significantly associated with color perception and photophobia.
  • A higher anesthetic volume (>4 mL) correlated with reduced anxiety related to visual experiences (P=0.003).

Conclusions:

  • Patients under regional anesthesia for cataract surgery report diverse visual sensations.
  • The perception of color and anesthetic volumes less than 4 mL are linked to more frightening visual experiences.
  • Comprehensive preoperative counseling regarding potential visual phenomena is mandatory to alleviate patient distress.