Authors: Francesca Lee¹, Steve Arshinoff², Eric S. Tam¹, Hannah Chiu¹, Lili Tong¹, Anil Arekapudi¹, Behrooz Yaghchi¹, Hermant Ghate¹, Sohel Somani¹. ¹Uptown Eye Specialists, ²York  
Finch Eye Associates.  
 

Author Disclosures:   F. Lee:  None.  S. Arshinoff:   Membership on advisory boards or speakers’ bureaus; Name of for-profit or not-for-profit organization(s); Alcon, Rayner, Zeiss, CIMA Life Sciences, Arctic Dx. Membership on advisory boards or speakers’ bureaus; Description of relationship(s); Consultant.  E.S. Tam:  None.  H. Chiu:  None.  L. Tong:  None.  A. Arekapudi:  None.  B. Yaghchi:  None.  H. Ghate:  None.  S. Somani:  None.  
 

Abstract Body: 

Purpose: To compare pain perception among patients undergoing immediately  sequential bilateral cataract surgery using either a manual (MCS) or refractive laser assisted  (ReLACS) technique, and the pain perception of patients receiving anesthesia at different time points during ReLACS 

Study Design: Prospective chart review. 

Methods: Patients undergoing immediate sequential bilateral cataract surgery were recruited. A sample size of 30 patients per group was calculated to detect a difference of 1 in the NRS, setting alpha at 0.05, power at 90%, and  assuming a standard deviation 1.31 according to previous studies. Patients were assigned to three  cohorts, MCS (n=35), ReLACS Standard‐patients who received neurolept anesthesia prior to draping  of the eye (n=33) or ReLACS Early‐patients who received neurolept anesthesia prior to the  femtosecond laser (n=34). Pain perception was measured, using NRS, at postoperative day 0 (POD0)  and at postoperative week one (POW1). Secondary outcome measures included anxiety scores (STAI  questionnaire), physician‐rated patient cooperation scores, intraoperative metrics, and perioperative systemic vitals. 

Results: There were no significant differences in pain perception among MCS and ReLACS Standard cohorts at POD0 and POW1 (P=0.236 and 0.392, respectively), or ReLACS Early (RE) and Standard (RS) cohorts (P=0.196 and 0.072 respectively). The median pain scores were found to be 0 among MCS, RS and RE groups for both POD0 and POW1. Higher surgeon cooperation was significantly associated with higher pain at POD0 and POW1 in RS vs. RE cohorts  (P=0.012 vs P=0.004), and at POD0 in MSC vs RS cohorts (P=0.022). No other variables, including  
anxiety scores, intraoperative metrics, and perioperative systemic vitals, had a significant effect on pain perception at POD0 or POW1. 

Conclusions: The technique used during cataract surgery or the timing of anesthesia for ReLACS procedure does not impact pain perception post‐surgery.