Use of ISBCS to optimize subjective perception of cataract surgery
Free Paper Details
First Author: P.Studeny CZECH REPUBLIC
Co Author(s): J. Vranova
Immediately sequential bilateral cataract surgery (ISBCS) is still a relatively controversial procedure with some advantages (lower cost, quicker visual rehabilitation, lower risk of nosocomial infection). The main concern is the risk of bilateral endophthalmitis and possible bilateral refractive error. Though, when the bilateral surgery is done in one day, it gives the possibility to distinguish well the effect of any minor changes in the surgical protocol on the patient's subjective perception of the operation.
Department of Ophthalmology, University Hospital Kralovske Vinohrady, Prague, Czech Republic Opthalmology Centrum Somich, Karlovy Vary, Czech Republic
During the surgery, we randomly changed one surgical parameter in one eye of each patient (illumination intensity of the operating microscope, pressure of the irrigation, using of intracameral anaesthesia, type of eyelid speculum etc). Each change was tested in group of 50 patients. At the end of both surgeries, the patients reported the magnitude of pain, the feeling of pressure and the glare on a numerical scale and they also estimated the duration of the surgery.
A number of changed parameters influenced the different perceptions of the right and left eye surgery. Though, these differences were usually not statistically significant. For example, perceived pain was statistically significantly lower in patients with an intracameral anaesthetic (0.34 at 0.44, p = 0.013). In eyes where anaesthetic was not used, the time perception of the surgery was prolonged (in comparison with real length of the surgery).
ISBCS can be used to set up the optimal parameters of the cataract surgery, so that the patient's perception of the operation is as enjoyable as possible.