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

Ophthalmology. 2000 Feb;107(2):248-50. doi: 10.1016/s0161-6420(99)00080-9.


Objective: The aim of this study was to investigate the subjective visual experience of patients during phacoemulsification and intraocular lens (IOL) implantation under topical anesthesia.

Design: Postoperative questionnaire survey.

Participants: The study cohort consisted of 52 patients with cataracts. There 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 implantation 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 during surgery.

Results: All patients (100%) reported that they could see at least some light during the surgery. Some patients reported they could also see one or more colors (50 patients, 96.2%), movements (32 patients, 61.5%), flashes (24 patients, 46.2%), the surgeon's fingers/hands (13 patients, 25%), instruments (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 light changed during the course of the operation. Eight patients (15.4%) found their visual experience frightening. There was no statistically significant association between those who found the visual experience frightening and the sex or age of the patient, a history of cataract operation in the fellow eye, the type of visual sensation experienced, or the presence of coexisting ocular pathology.

Conclusion: All patients undergoing phacoemulsification under topical anesthesia experience a variety of visual sensations that may be frightening in a small proportion of patients.

MeSH terms

  • Aged
  • Anesthesia, Local / methods*
  • Anesthetics, Local / administration & dosage
  • Cohort Studies
  • Color Perception
  • Female
  • Humans
  • Lens Implantation, Intraocular*
  • Male
  • Motion Perception
  • Phacoemulsification*
  • Surveys and Questionnaires
  • Visual Acuity
  • Visual Perception / physiology*


  • Anesthetics, Local