EyeWorld Asia-Pacific June 2014 Issue

40 EWAP CAtArACt/IOL June 2014 by Vanessa Caceres EyeWorld Contributing Writer Help patients relax for better cataract surgery cooperation Education, positive imagery techniques quelled anxiety in recent study T o cataract surgeons, performing surgery can seem like a routine task. However, to patients, it’s surgery they have only once or twice in their life—and that could bring on nervousness and anxiety. Surgical anxiety can affect a patient’s pain sensitivity, blood pressure, heart rate, compliance, and even IOP. A study published recently in the journal Patient Education and Counseling identified a way to help cataract surgery patients reduce their perioperative anxiety. 1 Investigators, led by Zoltán Kekecs , Eotvos Loránd University, Faculty of Education and Psychology, Department of Affective Psychology, Budapest, found that listening to an audio CD that included patient education as well as positive therapeutic suggestions to help manage anxiety made patients feel calmer and be more cooperative during their cataract operation. Study details In this randomized, controlled, single-blind study, 84 patients slated for cataract surgery were divided into two groups—one group (34 patients) received a 15-minute audio CD and were instructed to listen to the CD four times at home, including once during the night before the operation. They were told that listening to it four times would help get them familiar with the relaxation and imagery techniques. The script on the CD was designed with the help of a hypnotherapist experienced with the use of positive suggestions in the medical field and was read by the cataract surgeon whom the patients were already familiar with. The CD script explained the phases of the operation and the recovery period but also used positive suggestions and imagery techniques, such as focusing attention on breathing and imagining a safe place during the operation. Some of the script from the text included: “When you arrive in the forefront of the operating room you’ll get a number of eye drops. … It’ll be good to know that with every drop your pupil will be more dilated and dilated and your eye will get more and more anesthetized as long as it’s needed. … First your eye will be cleaned with a disinfectant solution. … Some imagine this like a pleasant cool breeze that washes away not only bacteria but the remaining tension as well.” The 50 patients in the control group did not listen to the audio CD. As part of standard procedure, all patients received the anti- anxiety medication alprazolam 0.25 mg in the perioperative room after an initial medical exam. Upon return to the clinic the following day, investigators asked