Abstract Background In modern psychosomatic medicine, cataract surgery is an invasive stressor that can easily induce perioperative psychological stress reactions such as anxiety and fear in elderly patients. Simple psychological scales are no longer sufficient to quantify the transient stress state of patients in specific medical examination contexts. The eye pressure caused by the contact measurement of ophthalmology A and the gaze coordination requirements of optical biometric instruments constitute a natural psychological stress induction test. The study mainly uses A-scan and biometric instruments to evaluate the preoperative mental health status of cataract patients, in order to provide scientific basis for precise preoperative psychological intervention in clinical practice. Methods 216 elderly patients who are scheduled to undergo cataract restoration surgery in the ophthalmology department of a tertiary hospital were selected as the observation subjects. Based on the preliminary psychological screening results at the time of enrollment, patients were divided into a psychologically stable group (108 cases) and a psychologically stressed group (108 cases). The study introduced the Hamilton Anxiety Rating Scale (HAMA) as the gold standard reference, while monitoring real-time physiological parameters of patients during A-contact measurement and optical biometric measurement. The recording indicators include heart rate variability during the measurement process, standard deviation of axial length measurement caused by nystagmus amplitude, average time required for a single successful measurement, and the number of times fixation is lost. Results Experimental data shows that patients in the psychological stress group exhibit significant sympathetic nervous system excitation characteristics and behavioral coordination disorders when facing examination instruments. The HAMA score of patients is significantly positively correlated with the standard deviation of eye axis measurement, indicating that the higher the level of psychological anxiety, the lower the accuracy of biometric data. Among them, the HAMA score of the psychological stress group was as high as 18.67 points, indicating a significant state of anxiety. The average heart rate during the examination reached 94.20 beats per minute, significantly higher than the 72.45 beats per minute in the stable group (p.05), reflecting a strong level of physiological arousal. The standard deviation of A-scan axial measurement, which reflects measurement accuracy, reached 0.28 mm in the stress group, while it was only 0.04 mm in the stable group, and the average measurement time was extended by nearly three times. Preoperative psychological disorders can directly interfere with the detection results of precision instruments through decreased nerve and muscle tension and coordination. Discussion Incorporating the variability of examination data from A-scan and biometric instruments into the psychological evaluation system can effectively compensate for the subjective bias of simple questionnaire surveys and achieve quantitative identification of preoperative hidden anxiety in cataract patients. This discovery suggests that clinical doctors should prioritize psychological intervention over simply repeating procedures when facing patients with measurement difficulties. Future research will consider developing psychological monitoring algorithms based on eye tracking technology and micro dilation changes in pupil diameter, exploring the application value of virtual reality technology in alleviating patients' expected anxiety during preoperative simulation examinations.
Yudong Chen (Sun,) studied this question.
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