Patients Recall Second Cataract Surgery Better Than First

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Patients remembered more events from their second eye procedure than their first, according to a survey.

Patients remembered more events from their second eye cataract surgery than their first, researchers found in a survey study published in the Journal of Cataract and Refractive Surgery.

The researchers sought to investigate whether their perception of patients saying they remembered the second eye surgery better than they remembered the first would match their investigation’s findings.

On postoperative day 1, they distributed a questionnaire to 274 patients who underwent either their first (199 eyes) or second (178 eyes) cataract procedure. All surgeries were conducted by the same surgeon, at a single ambulatory surgical center. The patients rated their awareness and recollection of events in the preoperative, operative, and postoperative periods and their level of discomfort during the surgical procedure on a scale of 0 (least discomfort) to 10 (most discomfort). Patients were also asked to compare their overall recollection of their first and second surgeries, if applicable.

Significantly more patients remembered intraoperative events during the second surgeries (63.3%) than the first (8.4%). A higher percentage of patients (89.4%) recalled “all” or “some” of the operating area than those who remembered “all” or “some” of their first eye cataract surgery (80.8%, P =.0496).

For both procedures, the best-remembered portion of the surgery was the preoperative area, as 82.4% of patients undergoing their first eye surgery remembered “all” of it while 80.9% of patients undergoing their second eye surgery remembered “all” of it (P =.894).

Many patients remembered “all” of the postoperative area of the surgeries (57.6% for the first surgery, 68% for the second, P =.0965).

“Many ophthalmic surgeons may find it counterintuitive that setting expectations is as, if not more, critical prior to second eye surgery,” the investigation says. “Preoperative expectation management appears to be an important aspect of reducing patient anxiety and fear, which has important implications for patient satisfaction.”

The researchers said the results can help patients prepare for the sensory perceptions they may experience during the surgery.

“Additionally, findings from this study may have implications for increased implementation of immediate sequential bilateral cataract surgery (ISBCS); 95% of surgeons in the Kaiser system reported that they performed ISBCS to improve patient convenience, namely less surgical time, and more rapid recovery times, and 91% of surgeons reported doing so per patient request,” the study notes.


Venkateswaran N, Wisely CE, Finklea B, Kim T. Comparison of patient perceptions of first and second eye cataract surgery. J Cat Refract Surg. Published online November 27, 2020. doi:10.1097/j.jcrs.0000000000000371