In their recent article, Aslankurt et al.1 describe differences in pain and cooperation among patients having dominant-side or nondominant-side phacoemulsif i-cation under topical and intracameral anesthesia. They report significantly higher visual analogue scale (VAS) pain scores and reduced cooperation scores in patients having surgery on the dominant side than in those having surgery on the nondominant side.Aslankurt et al. also report that 40 of 78 patients (51.3%) rated their pain severity as zero. Since the VAS scores range from 0 (no pain) to 10 (unbearable pain), this suggests that the pain scores from this group of patients do not follow a normal distribution but are skewed toward the lower end of the scale, as one would expect for pain experienced during phaco-emulsification. Similar observations have been made in earlier studies, in which the median VAS score was either 1 or 0.
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