Comparison of pain perception in immediate vs delayed sequential bilateral cataract surgery

To compare patient-reported pain perception between immediate sequential vs delayed sequential bilateral cataract surgery (ISBCS vs DSBCS).

King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Prospective cohort study.

Eligible participants scheduled to undergo ISBCS and DSBCS were consecutively enrolled. Topical anesthesia was administered for all procedures with no sedation used. Pain scores for each eye were assessed separately at 3 timepoints: immediately after surgery, day 1, and day 7 postoperation, using a verbal numeric rating scale from 0 to 10. A linear mixed-effects model was used to analyze the differences in pain scores between the 2 groups and adjusted for covariates, including surgical method, timepoint, operated eye, education level, surgeon experience, and surgical duration.

90 bilateral cataract patients (45 ISBCS and 45 DSBCS) were enrolled. Pain scores on day 0 were low, with medians of 1 (0; 2) for both groups ( P = .476). The linear mixed-effects model revealed no significant impact of surgical methods on pain scores, with a notable decrease in pain levels over time. Surgical duration significantly affected pain, with each minute adding approximately 0.027 to the score. In addition, patients with higher education levels reported higher pain scores.

Pain related to cataract surgery was mild and resolved quickly in both ISBCS and DSBCS groups, with no significant differences between surgical methods and operated eyes. The effect of education level on pain perception suggests the importance of good preoperative counseling to set appropriate expectations.