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Preoperative counseling of patients for phacoemulsification cataract surgery: are we preparing patients adequately?

Poster Details

First Author: M.Khan UK

Co Author(s):    W. Tang   M. Tahhan           

Abstract Details

Purpose:

Very few studies have explored patient perceptions during phacoemulsification cataract surgery and the majority of these are limited to the visual experience. The patient experience however is not simply limited to visual perceptions: there are auditory perceptions (inc. phaco machine), facial touch, drape and other sensations including water flow. The purpose of this study was to explore consent practice for routine phacoemulsification cataract surgery and to ascertain what proportion of patients was routinely being informed about these perceptions, in addition to the most common operative risks, pre-operatively.

Setting:

The Eye Unit, Sandwell General Hospital, Birmingham, United Kingdom.

Methods:

Fifty consecutive patients were asked about their experiences immediately post cataract surgery through a structured questionnaire. This included querying about visual perceptions (ranging from brightness and colour of light to instrument/ hand movement), noise (‘buzzing/ hissing’, talking), drape covering face and other sensations including facial touch, water flow down face and wetness of the back of the head.

Results:

While all patients had been informed about the most common operative risks, there was great variability in the additional information provided. The majority of patients felt that sensation of touch and water flow bothered them the most (50%), followed by visual perceptions (42%) and then noise (8%). Fifty-four percent of patients felt intra-operative noise contributed to their anxiety and facial touch was experienced by 84% of patients, whereas 96% felt water flow down the face. The majority of patients had not been informed about these common intra-operative perceptions and the overwhelming majority would prefer to be told about them.

Conclusions:

This is the first study of its kind holistically assessing the patient perceptions of phacoemulsification cataract surgery. All patients should be routinely informed about bright light including instrument/ hand movement, noise including ‘buzzing/hissing’ of the phaco machine, the presence of a drape and facial touch including the feeling of water flowing down the face. We propose routinely conveying this information to all patients at the pre-operative counseling/ consent stage. This not only helps to reduce patient anxiety but also creates an optimal environment for both the patient and the surgeon.

Financial Disclosure:

NONE

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