Factors affecting patient cooperation and level of pain perception during phacoemulsification in topical and intracameral anesthesia

Eur J Ophthalmol. Nov-Dec 2009;19(6):977-83.


Purpose: To evaluate selected factors that may influence pain perception and patient cooperation with the surgeon during phacoemulsification performed under topical and intracameral anesthesia.

Methods: A total of 203 consecutive patients who had uncomplicated cataract phacoemulsification with foldable intraocular lens implantation through clear corneal 2.8 mm temporal incision under topical anesthesia were enrolled into the study. The factors assessed included gender, age, level of education, professional activity, place of residence, pain sensitivity declared preoperatively, patient mood before operation, preoperative visual acuity, and whether it was the patient's first or second cataract surgery. The correlation between postoperatively declared level of pain perception and cooperation with the surgeon was also evaluated. For statistical analysis, gamma correlation coefficient test was used.

Results: The strongest correlation was found between gender and cooperation and level of perceived pain. The weakest dependencies were noticed between the level of education and these parameters. Women, patients who were professionally active, and patients who were in a better mood before the operation were more cooperative. A strong correlation was found between patient pain perception and cooperation.

Conclusions: Pain perception was positively influenced by female gender, rural place of residence, younger age of patient, and lower preoperative visual acuity. Cooperation with the surgeon was positively influenced by female gender, professional activity, patient good mood before operation, and no pain perception during surgery. There was no correlation between level of education, preoperatively declared pain sensitivity, sequence of operation, and estimated parameters.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / methods*
  • Anesthetics, Local / administration & dosage
  • Cataract / complications
  • Educational Status
  • Female
  • Humans
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Pain / psychology*
  • Pain Measurement
  • Patient Compliance / psychology*
  • Phacoemulsification*
  • Sex Factors
  • Visual Acuity / physiology


  • Anesthetics, Local