Comparison of Pain Perception in Immediate versus Delayed Sequential Bilateral Cataract Surgery

Purpose: To compare patient’s reported pain perception between immediate sequential versus delayed sequential bilateral cataract surgery (ISBCS vs. DSBCS). Setting: King Chulalongkorn Memorial Hospital, Bangkok, Thailand Design: Prospective cohort study Methods: Eligible participants scheduled to undergo ISBCS and DSBC were consecutively enrolled. Topical anesthesia was administered for all procedures with no sedation used. Pain scores for each eye were assessed separately at 3 time points: immediately after surgery, day 1, and day 7 postoperation, using a verbal numeric rating scale from 0 to 10. A linear mixed-effects model was used to analyze the differences in pain scores between the two groups and adjusted for covariates, including surgical method, time point, operated eye, education level, surgeon experience, and surgical duration. Results: A total of 90 bilateral cataract patients (45 ISBCS and 45 DSBCS) were enrolled. Pain scores on Day 0 were low, with medians of 1 [0; 2] for both groups (p = 0.476). The linear mixed-effects model revealed no significant impact of surgical methods on pain scores, with a notable decrease in pain levels over time. Surgical duration significantly impacted pain, with each minute adding approximately 0.027 to the score. Additionally, patients with higher education levels reported higher pain scores. Conclusions: Pain related to cataract surgery was mild and resolved quickly in both ISBCS and DSBCS groups, with no significant differences between surgical methods or operated eyes. The effect of education level on pain perception suggests the importance of good preoperative counseling to set appropriate expectations.