Subjective visual experience during phacoemulsification and intraocular lens implantation under topical anesthesia

Objective: The aim of this study was to investigate the subjective visual e xperience of patients during phacoemulsification and intraocular lens (IOL) implantation under topical anesthesia. Designs Postoperative questionnaire survey. Participants: The study cohort consisted of 52 patients with cataracts. The re were 18 male (34.6%) and 34 female (65.4%) patients. Their mean (+/-SD) age was 67.5 (+/-10.8) years. Intervention: The patients underwent routine phacoemulsification and IOL im plantation under topical anesthesia. Main Outcome Measures: The patients were interviewed on the same day after their operation regarding their visual experience in the operated eye durin g surgery. Results: All patients (100%) reported that they could see at least some lig ht during the surgery. Some patients reported they could also see one or mo re colors (50 patients, 96.2%), movements (32 patients, 61.5%), flashes (24 patients, 46.2%), the surgeon's fingers/hands (13 patients, 25%), instrume nts (12 patients, 23.1%), and/or the surgeon (4 patients, 7.7%). The colors seen included red (24 patients, 46.2%), yellow (23 patients, 44.2%), blue (12 patients, 23.1%), green (7 patients, 13.5%), and orange (6 patients, 11 .5%). Eight patients (15.4%) saw the spectrum of colors similar to that of the rainbow.-Twenty-four patients (46.2%) reported that the brightness of l ight changed during the course of the operation. Eight patients (15.4%) fou nd their visual experience frightening. There was no statistically signific ant association between those who found the visual experience frightening a nd the sex or age of the patient, a history of cataract operation in the fe llow eye, the type of visual sensation experienced, or the presence of coex isting ocular pathology. Conclusion: All patients undergoing phacoemulsification under topical anest hesia experience a variety of visual sensations that may be frightening in a small proportion of patients. (C) 2000 by the American Academy of Ophthal mology.