Visual Experience During Phacoemulsification-Trabeculectomy Under Peribulbar Anesthesia

BACKGROUND AND OBJECTIVE: To investigate the subjective visual experience of patients with concurrent cataract and glaucoma during phacoemulsification-trabeculectomy under peribulbar anesthesia. PATIENTS AND METHODS: Consecutive patients with concurrent cataract and glaucoma who underwent phacoemulsification-trabeculectomy under peribulbar anesthesia for the first time were interviewed using a standardized questionnaire between 30 minutes and 4 hours after the surgery. They were asked about their intraoperative visual experiences and their reaction to their visual experience. There was no preoperative discussion with the patients on possible intraoperative visual sensations that they might experience. No preoperative or intraoperative sedation was used. RESULTS: Sixty patients with a mean age of 64.8 years (range: 41 to 86 years) were included in the study.Light perception was reported by 73.3% of patients and no light perception by 26.7% throughout the operation. Some patients reported they could also see movements (65%), flashes (53.3%), one or more colors (48.3%), a change in light brightness (38.3%), instruments (8.3%), and/or the surgeon/medical staff (1.7%). Of the 29 patients (48.3%) who saw one or more colors, 18 patients saw yellow, 12 blue, 4 green, 2 orange, and 1 red. One patient (1.7%) found the visual experience frightening and the rest (98.3%) found theirs pleasant. CONCLUSION: The majority of patients with concurrent cataract and glaucoma undergoing phacoemulsification-trabeculectomy using peribulbar anesthesia experience a variety of visual sensations, although only a minority was frightened by the visual experience.