|LETTER TO THE EDITOR
|Year : 2012 | Volume
| Issue : 2 | Page : 137-138
The effect of gender on pain experienced during cataract surgery
Colin S. H. Tan1, Louis W. Y. Lim2, Milton C. Y. Chew2, Kelvin Z Li2, Wei K Ngo2
1 Department of Ophthalmology, Tan Tock Seng Hospital, Singapore
2 National Healthcare Group Eye Institute, Singapore
|Date of Web Publication||4-Aug-2012|
Colin S. H. Tan
National Healthcare Group Eye Institute, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng - 308433
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Tan CS, Lim LW, Chew MC, Li KZ, Ngo WK. The effect of gender on pain experienced during cataract surgery. Oman J Ophthalmol 2012;5:137-8
We read with interest the article describing pain experienced during cataract surgery under topical anesthesia  and agree with Gupta and colleagues that control of perioperative pain is very important, because it affects patient comfort and satisfaction with the surgery as well as their cooperation during the procedure. There are many possible, interrelated factors affecting pain, including gender, age, or even ethnic and cultural differences. However, regardless of the exact reason, it is important to identify patients who are at greater risk for pain. This allows doctors to take definitive steps to alleviate their pain during the surgery.
The authors correctly state that there are few studies on factors affecting pain during cataract surgery. We would like to highlight the results of two other studies, which examined the role of gender on pain experienced during cataract surgery, and hope that this will stimulate discussion on this important topic. In a study of 204 patients undergoing cataract surgery under topical anesthesia with and without supplemental intracameral lidocaine, Gillow et al. performed multiple regression analysis and found no significant relationship between pain and gender.  In a double-masked, randomized clinical trial of 506 patients, multivariate analysis revealed that females were more likely to experience pain than males (54.3% vs. 43.6%, odds ratio 1.56, P = 0.016) after accounting for other factors such as age. 
In the current study,  females had higher mean pain scores than males for both surgical techniques - 0.95 vs. 0.423 for phacoemulsification and 1 vs. 0.825 for manual small incision cataract surgery (MSICS). Although the difference between the visual analog scale scores were not statistically significant, the P value did approach statistical significance (P = 0.054). It is possible that with a larger sample size, a significant difference may have been detected. Also, the pain experienced is generally quite low (with a median of 0 for all groups). Therefore, it might be useful to consider the percentage of patients who experienced pain of any severity. Comparing the phacoemuslfication group, 42.5% of females experienced some pain, compared with 17.5% for males, whereas no difference was found between genders in the MSICS groups. It would be interesting to know if the difference in percentage of patients experiencing pain in the phacoemulsification group was statistically significant.
In summary, this study is very useful and contributes important information regarding the possible effect of gender on pain perception during cataract surgery. Additional studies will be required to confirm the risk factors and study possible measures to alleviate pain.
| References|| |
|1.||Gupta SK, Kumar A, Agarwal S. Cataract surgery under topical anesthesia: Gender-based study of pain experience. Oman J Ophthalmol 2010;3:140- 4. |
|2.||Gillow T, Scotcher SM, Deutsch J, While A, Quinlan MP. Efficacy of supplementary intracameral lidocaine in routine phacoemulsification under topical anesthesia. Ophthalmology 1999;106:2173-7. |
|3.||Tan CS, Fam HB, Heng WJ, Lee HM, Saw SM, Au Eong KG. Analgesic effect of supplemental intracameral lidocaine during phacoemulsification under topical anaesthesia: A randomised controlled trial. Br J Ophthalmol 2011;95:837-41. |