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Published on: September 20, 2024
Documenting the subjective patient experience of first vs second eye during immediately sequential bilateral cataract
Carmen Balian1, Jack E Teplitsky, Wissam Nassrallah
1From the Kensington Health Research Institute, Toronto, Ontario, Canada (Balian); Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada (Teplitsky); University of British Columbia, British Columbia, Canada (Nassrallah); Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Sayal); Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada (Braga-Mele, El-Defrawy, Lloyd, Amandeep S. Rai); Kensington Eye Institute, Toronto, Ontario, Canada (Braga-Mele, El-Defrawy, Amrit S. Rai, Lloyd, Amandeep S. Rai).
Purpose:
To investigate if patients had a subjectively inferior experience during second-eye surgery vs first-eye surgery during immediate sequential bilateral cataract surgery (ISBCS) as both operations were performed within the same surgical visit.
Setting:
Multisurgeon ophthalmic surgical center.
Design:
Survey-based prospective design.
Methods:
Patients of the center undergoing routine cataract surgery who enrolled in the study completed a questionnaire immediately after surgery to describe their surgical experience for each eye. Survey questions measured patient pain, discomfort or pressure, comfort, relaxation, estimated length of surgery, and predicted visual outcome.
Results:
Patient-reported level of pain during the second-eye surgery was significantly greater than for the first eye ( P < .001). Furthermore, the order of surgery was found to be a strong predictor of patient-reported pain ( P < .001), more so than surgical length ( P < .008), additional anesthesia ( P < .35), patient age ( P < .44), or patient sex ( P < .88). Overall, surgery during the first eye was reported as more comfortable ( P < .001) and shorter in duration ( P < .001), while discomfort and pressure were reported as worse for the second eye ( P < .001).
Conclusions:
Understanding differential experiences between eyes can help surgeons when counselling patients regarding expectations for ISBCS and related visual outcomes.
