Second Eye Syndrome: Patients' Perspectives Regarding First Eye versus Second Eye Phacoemulsification and Intraocular...

"Second eye syndrome" is a term used to reflect the feeling of more pain, anxiety, and longer duration of second eye cataract surgery than first eye cataract surgery. Many theories were elaborated to explain this phenomenon. This study aims to assess the subjective responses of pain, anxiety, duration of surgery, and recovery of patients who underwent bilateral uncomplicated cataract surgery.

A cross-sectional design utilizing a well-structured questionnaire was adopted in this study. All patients who underwent bilateral uncomplicated cataract surgery through phacoemulsification and intraocular lens implant, with similar best-corrected visual acuity in both eyes, were interviewed through and after each surgery. Demographics, medical history, and preoperative and operative details were collected.

In this study, 347 patients were included; 199 (57.3%) were males. The operations were without intraoperative complications for both eyes. The mean value of the VAS score of the first eye was 1.95 and was 2.37 for the second eye (P = 0.02). Seventy (20.2%) patients reported that second eye surgery was more painful in comparison to 26 (7.5%) patients who reported the first eye to be more painful. The overall experience for the second eye was better in 56 (16.1%) cases and worse in 141 (40.6%). No medical or operative factor was found to affect the responses.

This study revealed that patients perceived more pain and less quality of visual recovery in the second eye surgery, which could be associated with psychological factors. We would suggest that all cataract surgeons pay attention to informing and reassuring patients that they are likely to feel more pain during the second eye operation.