To investigate the relationship between maturity of a cataract and the pattern of pain during cataract surgery under topical anesthesia.

This study comprised 105 eyes of 75 patients undergoing cataract surgery under topical anesthesia. The pain scale during each procedure was scored from 0 to 10 in numeric pattern and analyzed with the cataract maturation degree. Additionally, pain scores were compared between the first and the second eye in 14 consecutive cataract patients.

The average pain score during cataract surgery was 0.86 ± 0.55, and the average maximal pain experience score during surgery was 3.24 ± 1.51, which was generally tolerable. Phacoemulsification was marked as the most painful step among cataract surgery procedures (1.93 ± 1.64), followed by the removal of the surgical draping (1.31 ± 1.53) and the initial instillation of topical anesthetic (1.29 ± 1.28). Progression and cataract typing was not related to pain either during overall cataract surgery procedures or when separately analyzed during procedures. There was no significant difference between the pain scores reported in consecutive cataract surgeries. However, in subjective comparison of consecutive surgeries, more patients reported greater pain in the second operation.

The pain score reported during cataract surgery procedures under topical anesthesia was within a generally tolerable range. Cataract progression does not appear to be related to pain during the operation. In consecutive surgeries, pain measured by a numerical scale and subjective pain experience showed different results.