A comparison of Patient Perceptions undergoing Manual vs Refractive Laser‐Assisted ISBCS

Author Block: Francesca Lee 1, Steve Arshinoff 2, Eric S. Tam 1, Hannah Chiu 1, Lili Tong 1, Anil
Arekapudi 1, Behrooz Yaghchi 1, Hermant Ghate 1, Sohel Somani 1. 1Uptown Eye Specialists, 2York
Finch Eye Associates.
 

Author Disclosure Block:   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.