Patient pain during stretching of small pupils in phacoemulsification performed using topical anesthesia

Purpose

To assess the pain experienced by patients with small pupils during pupil stretching in phacoemulsification performed using topical anesthesia.

Setting

Royal Victoria Eye & Ear Hospital and Mater Misericordiae University Hospital, Dublin, Ireland.

Methods

This was a prospective study that included 26 eyes with small pupils requiring mechanical pupil stretching during phacoemulsification cataract surgery performed under topical anesthesia without sedation.

Results

The mean pain score for the instillation of anesthetic drops (2.02) was higher than the mean pain score for the pupil stretch (1.63), but this difference was not significant (signed rank test = −32; P = .2738). There was no significant correlation between the duration of surgery and the overall pain score (r = 0.345; P = .08). There was no significant correlation between change in pupil size and either the pupil stretch score (r = −0.069; P = .74) or the overall pain score (r = −0.032; P = .8739).

Conclusions

Pupil stretching during phacoemulsification in patients with small pupils was performed with minimal patient-reported pain using topical anesthesia. Stretching small pupils with a mechanical device during phacoemulsification performed under topical anesthesia was a safe procedure and did not result in significant patient discomfort.