Intervention to Reduce Anxiety Pre- and Post-Eye Surgery in Pediatric Patients in South Korea: A Preliminary Quasi-Experimental Study

In this study, we aimed to identify the effect of preoperative information on postoperative anxiety among children undergoing one-day eye surgery. We utilized a nonequivalent control group and a pretest–posttest quasi-experimental design. The participants were 15 children in the experimental group and 15 children in the control group. Preoperative information was provided to the experimental group in the waiting room. Anxiety level was measured using the Children’s Emotional Manifestation Scale and pulse rate. For pulse rate, there were no statistically significant differences between the groups. In the behavioral anxiety response, there were statistically significant differences between the experimental and control groups (Z = −4.15, p < 0.001). The results suggest that the provision of preoperative information can be an effective intervention for reducing postoperative anxiety and improving the health of children undergoing surgery.

Correlation between Hyperalgesia and Upregulation of TNF-α and IL-1β in Aqueous Humor and Blood in Second Eye Phacoemulsification: Clinical and Experimental Investigation

The aim of this study was to explore the correlation between intraoperative hyperalgesia of the second eye and the dynamic changes of tumor necrosis factor (TNF)-α and interleukin (IL)-1β levels in aqueous humor (AH) of the second eye and whole blood after the first eye cataract surgery. A rabbit model of monocular phacoemulsification was established by administration of 0.3% levofloxacin. Whole blood and AH samples from non-surgical eyes in the experimental group (n =25) and second eye in the blank control group (n =15) were obtained and corneal sensitivity was examined after surgery (1, 3, 7, 14, and 21 days postoperatively). TNF-α and IL-1β levels in AH and TNF-α mRNA and IL-1β mRNA levels in whole blood were measured. In a clinical study, 30 patients who underwent bilateral phacoemulsification within 1 month were divided into six groups in accordance with the operation intervals (1, 3, 7, 10, 14, and 21days). TNF-α and IL-1β levels in AH were measured at the beginning of surgery and intraoperative pain was assessed immediately after surgery. Corneal sensitivity (F =244.910, P <0.05), TNF-α and IL-1β levels in AH (F =184.200, 82.900, P <0.05) of non-surgical eyes and in whole blood (F =272.800, 193.530, P <0.05) in the experimental group were significantly higher than the baseline levels after phacoemulsification. In the clinical study, NRS scores of second eye surgery were higher than those of the first eye(P =0.0025) and 19 (63.3%) patients reported more pain during the second eye surgery. TNF-α and IL-1β concentrations in AH of the second eye were significantly higher than those of the first eye (F =123.60, P <0.05; F =59.60, P <0.05). In conclusion, within 1 month after the first eye phacoemulsification, higher pain sensitivity (hyperalgesia) exists in the second eye, which may be related to dynamic changes in TNF-α, IL-1β levels in AH or whole blood.

Eye Surgery in Africa

No Abstract.

Comparative Assessment of Pain in Sequential Cataract Surgery with Topical Phacoemulsification - A Prospective Observational Study from a Tertiary Care Hospital in Uttar Pradesh

BACKGROUND With the advancement in anaesthetic measures, a safe and effective alternative to peribulbar and retrobulbar anaesthesia for phacoemulsification is provided by topical anaesthesia.1 (Fichman, 1996). Studies highlighting varied pain experiences have been published with some reporting higher pain in second eye surgery,2,3 (Ursea et al. 2011; Tan et al. 2011) while others did not.4,5 (Bardocci, 2011; HariKovacs, 2012). So, we conducted this study to assess and compare pain experienced by patients subjectively as well as objectively in first and subsequent eye following topical phacoemulsification cataract surgery. METHODS A prospective observational clinical study was done for a duration of two years at Institute of Ophthalmology, Jawaharlal Nehru Medical College, AMU Aligarh. Study groups consisted of patients having bilateral cataract, to be operated in both eyes undergoing topical phacoemulsification and placement of an intraocular lens within one-year interval. Subjective as well as objective assessment of postoperative pain was done in the recovery room. RESULTS A total of 60 patients were included in the study with 51 (85 %) patients having higher pain score for second eye surgery as compared to first eye surgery, which was also significant while comparing their mean pain score (0.73  0.86 vs 2.17  0.91). Systolic and diastolic blood pressure as well as mean arterial pressure (MAP) were higher in first eye surgery as compared to second eye surgery. CONCLUSIONS In our comparative study, we observed higher pain in second eye surgery. As this subjective assessment of higher pain was not supplemented by objective assessment, we concluded that it may be due to more apprehension and uneasiness because of previous surgery. Patients going for second eye surgery should be prior consulted as well as managed properly. KEYWORDS Cataract, Pain, Topical Phacoemulsification