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Preoperative anxiety portends pain during cataract surgery

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SAN DIEGO — Patients with preoperative anxiety are at greater risk of feeling pain during cataract surgery, according to a study.

“Preoperative anxiety was the only significant predictor of pain during cataract surgery,” Michael Mimouni, MD, said at the American Society of Cataract and Refractive Surgery annual meeting.

A prospective, observational study included 103 eyes of 103 patients who underwent clear corneal incision phacoemulsification under local anesthesia at Rambam Health Care Campus, Haifa, Israel, between 2016 and 2018. Patient anxiety levels were evaluated using the visual analogue scale for anxiety before surgery, and pain was evaluated using the visual analogue scale for pain immediately after surgery. Both were measured on a scale of 0 to 10.

Severe pain and severe anxiety were both defined as a score of 7 or greater.

The mean anxiety score among patients was 3.69, and the mean pain score was 3.62. Severe pain was found in 16% of patients and severe anxiety in 17%. A patient with severe anxiety was 12.4 times more likely to experience severe pain during surgery (P < .001).

By using an anxiety cut-off value of 3 or more, ophthalmologists can identify 91.2% of patients who will have severe pain with a specificity of 67.5%, Mimouni said.

“Those that received anxiolytics did not experience less pain than those without. This tells us we need additional methods for reducing anxiety, and this should be assessed so we can improve patient compliance and perhaps reduce complication rates,” he said. – by Robert Linnehan

Reference:

Mimouni M. Anxiety levels and pain during cataract surgery. Presented at: American Society of Cataract and Refractive Surgery annual meeting; May 3-7, 2019; San Diego.

Disclosure: Mimouni reports no relevant financial disclosures.