Pain and cooperation in patients having dominant-side or nondominant-side phacoemulsification

Abstract

Purpose: To evaluate the relationship between laterality and perceived pain and cooperation during phacoemulsification under combined topical and intracameral anesthesia.

Setting: University ophthalmology clinic and eye hospital, Kahramanmaraş, Turkey.

Design: Cohort study.

Methods: Seventy-eight patients with senile cataracts who had ocular surgery were included prospectively. The dominant side was determined with the Edinburg Handedness Inventory. Phacoemulsification and intraocular lens implantation were performed. The surgeon graded the patient's cooperation from 0 (best) to 3 (worst). The duration of surgery was recorded. Another researcher rated perceived pain from 0 (no pain) to 10 (unbearable pain) using a visual analogue scale (VAS). Pain scores and the degree of cooperation for dominant-side and nondominant-side surgery were the primary outcomes.

Results: Forty-six patients had surgery in the dominant eye and 32 in the nondominant eye. The 2 groups were similar in age, sex, and severity and type of cataract. The mean VAS score was significantly higher in patients having dominant-side surgery than in those having nondominant-side surgery (P<.01). Similarly, the mean cooperation score was significantly poorer in the patients having dominant-side surgery (P<.05). Visual analogue scores were correlated with patient cooperation (r = 0.890, P<.0001).

Conclusion: Pain scores were higher in dominant-side surgery for cataract under topical and intracameral anesthesia, which should be kept in mind when selecting anesthesia and in studies in which pain is scored.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.