Cataract patients need counsel to reduce fearful reactions to visual experiences during surgery

Kah-Guan Au Eong

NUSA DUA, Indonesia — Because a majority of patients experience visual stimuli during cataract surgery, surgeons should counsel them before surgery to reduce fearful reactions that can endanger the success of the surgery, a speaker here said.

In a presentation at the joint meeting of the Asia-Pacific Academy of Ophthalmology and the American Academy of Ophthalmology, Kah-Guan Au Eong, MD, said his research has shown that "the majority of patients experience a wide variety of visual sensations during cataract surgery under topical anesthesia or retrobulbar anesthesia."

Dr. Au Eong said a significant proportion of patients are frightened by what they see.

He and his colleagues performed a randomized, prospective multicenter trial of 219 patients to show whether preoperative counseling reduced that fear. They found the mean fear score among those who received preoperative counseling was 0.3 vs. 0.9 in the group that had not received counseling. They also found that of those counseled, 13.5% were frightened during surgery vs. 19.1% of those who were not.

"The effect of counseling on fear was significant, even after controlling for sex, age, and whether first or second eye surgery," Dr. Au Eong said. "Preoperative counseling about potential visual sensations may alleviate this fear."