Effect of preoperative counseling on patient fear from the visual experience during phacoemulsification under topical anesthesia: Multicenter randomized clinical trial

Abstract

PURPOSE: To determine whether preoperative counseling about potential intraoperative visual experience during phacoemulsification under topical anesthesia reduces fear in patients having cataract surgery. SETTING: The Eye Institute at Tan Tock Seng Hospital, Singapore, Royal Hull Hospitals NHS Trust, Kingston-upon-Hull, and Manchester Royal Eye Hospital, Manchester, United Kingdom. METHODS: In this prospective multicenter randomized clinical trial, patients with cataracts having elective phacoemulsification under topical anesthesia were recruited and randomized into 2 groups. Both groups received routine preoperative counseling regarding risks and benefits of cataract surgery. One group received additional counseling on the potential intraoperative visual experience during phacoemulsification; the other group did not. The patients were then interviewed within 24 hours following phacoemulsification regarding their intraoperative experience. RESULTS: Two hundred nineteen patients were recruited over an 11-month period. There were 104 men and 115 women. The mean age was 68 years (range 20 to 89 years). There were 188 Singaporeans, comprising 168 Chinese, 13 Malays, and 7 Indians, and 31 British patients, all of whom were white. The mean fear score was 0.3 in the group that received additional counseling and 0.9 in the group that did not receive additional counseling (P = .036). The effect of counseling on fear was significant (P = .002) even after controlling for sex, age, and whether first or second cataract surgery. CONCLUSIONS: Preoperative counseling about the potential intraoperative visual experience during phacoemulsification under topical anesthesia helped to reduce the fear from the visual sensations in patients having cataract surgery. © 2005 ASCRS and ESCRS.