The Stress of Cataract Surgery

Abstract

Background: To assess the stress levels of three different grades of surgeons during cataract surgery. Design: Observational study. Open Access Open Access Participants: Three healthy male ophthalmic surgeons (Surgeon A, a specialty trainee, Surgeon B, a cataract surgery fellow, and Surgeon C, a consultant) were studied during 95 consecutive uncomplicated local anaesthetic phacoemulsi cation cataract extraction procedures. Methods: A pulse oximeter was used to record the heart rates of the 3 surgeons while they operated. The readings were taken at baseline and at every 2 seconds during the operation. The percentage change from baseline for each stage was compared for individual surgeons and amongst the three surgeons using one-way ANOVA test. Results: Observations were recorded on 29 cases for Surgeon A and 33 cases each for Surgeon B and Surgeon C. Overall there was a signi cant increase for capsulorhexis (p=0.007), phacoemulsi cation (p<0.001) and lens implantation (p=0.002) and wound closure (p=0.149). Surgeon A showed highest elevation during phacoemulsi cation (p<0.001). Surgeon B did not demonstrate a higher increase at a particular stage (p=0.103); and Surgeon C had a higher heart rate towards the completion of the procedure (p<0.001). Conclusions: Published reports have highlighted the stress surgeons in different specialties undergo. Ours is the rst study to demonstrate a change of heart rate from the baseline and hence stress between cataract surgeons of different grades. This change may be attributed to the difference between their experience and skills. Further studies can be undertaken to better identify stages of greater stress and means to reduce it.