Temerty Faculty of Medicine, University of Toronto, Toronto, ON; Uptown Eye Specialists, Toronto, ON.
Uptown Eye Specialists, Toronto, ON; Faculty of Medicine, University of Ottawa, Ottawa, ON.
Can J Ophthalmol. 2024 Jun;59(3):139-145. doi: 10.1016/j.jcjo.2023.03.013. Epub 2023 Apr 14.
To assess pain perception in patients undergoing manual cataract surgery versus femtosecond laser-assisted cataract surgery (FLACS) and pain perception of patients receiving anaesthesia at 2 different time points during the FLACS procedure. We also aimed to assess the factors affecting pain perception in these different study groups.
Prospective cohort comparison of patient-selected surgical approach.
Patients undergoing delayed sequential bilateral cataract surgery at an ambulatory surgical centre in Ontario.
Patients were assigned to 3 groups: a manual cataract surgery cohort (n = 30) and 2 FLACS cohorts, those who received neurolept anaesthesia just prior to draping for phacoemulsification (FLACS standard cohort; n = 38) and those who received neurolept anaesthesia prior to the femtosecond laser part of the procedure (FLACS early cohort; n = 35). Outcome metrics included pain scores on the visual analogue scale on postoperative day 0 and at postoperative week 1. Secondary outcome measures included anxiety scores, surgeon or anaesthesiologist patient cooperation scores, ocular metrics, and perioperative systemic vitals.
There were no significant differences in pain perception on postoperative day 0 and at postoperative week 1 among the manual cataract surgery and FLACS standard cohorts (p = 0.94 and p = 0.72, respectively) or FLACS early and FLACS standard cohorts (p = 0.76 and p = 0.67, respectively). Patients had higher pain scores during second-eye procedures than first-eye procedures.
Cataract surgery technique or timing of anaesthesia for FLACS procedures does not affect pain perception postoperatively. Second-eye procedures are associated with higher pain scores than first-eye procedures.
评估行手动白内障手术与飞秒激光辅助白内障手术（FLACS）患者的疼痛感知，并评估在 FLACS 手术过程中不同时间点给予麻醉的患者的疼痛感知。我们还旨在评估这些不同研究组中影响疼痛感知的因素。
患者选择手术方式的前瞻性队列比较。
在安大略省一家日间手术中心行延迟序贯双侧白内障手术的患者。
患者被分为 3 组：手动白内障手术组（n=30）和 2 个 FLACS 组，一组在进行超声乳化前即刻给予神经安定麻醉（FLACS 标准组；n=38），另一组在进行飞秒激光部分手术前给予神经安定麻醉（FLACS 早期组；n=35）。主要结局指标包括术后第 0 天和第 1 周的视觉模拟评分（VAS）疼痛评分。次要结局指标包括焦虑评分、外科医生或麻醉师的患者配合评分、眼部指标和围手术期全身生命体征。
在术后第 0 天和第 1 周，手动白内障手术组和 FLACS 标准组之间（分别为 p=0.94 和 p=0.72）或 FLACS 早期组和 FLACS 标准组之间（分别为 p=0.76 和 p=0.67）的疼痛感知无显著差异。双眼手术的患者疼痛评分高于单眼手术。
FLACS 手术技术或麻醉时机不会影响术后疼痛感知。双眼手术比单眼手术疼痛评分更高。
