Stress in Cataract Surgery: Determinants and Coping Strategies

Abstract

Purpose: This study examined the determinants of perioperative stress during cataract surgery and the coping strategies used by Moroccan ophthalmologists. Methods: A prospective cross-sectional analytical study was conducted from August to October 2024 using an anonymous online questionnaire. The sample comprised 212 ophthalmologists, including 92 residents, 110 specialists, and 10 professors. Demographic characteristics, cumulative cataract-surgery experience, perceived stress on a 10-point Likert scale, stress-inducing clinical situations and operative stages, coping strategies, and career satisfaction were assessed. Descriptive and comparative analyses and simple linear regression were performed. Results: Overall, 53.0% of participants were aged 30–40 years and 54.1% were women. Residents reported higher perioperative stress than specialists and professors (mean score, 6.42 vs. 4.40; p < 0.05). Specialists and professors had performed a mean of 2,150 cataract procedures, compared with 194 among residents. Performing more than 1,000 procedures was associated with lower perceived stress. Monocular and socially influential patients were the most stressful clinical scenarios, while continuous curvilinear capsulorhexis and nucleus phacoemulsification were the most stressful operative stages. During complications, 64% of respondents reported remaining calm and focused, and 42% sought assistance from colleagues. Discussion with colleagues and religious practices were the principal preoperative coping approaches, whereas physical and leisure activities predominated as long-term strategies. Conclusion: Perioperative stress was associated with professional seniority, operative experience, gender, and case complexity. Structured supervision, simulation-based education, mentorship, and accessible well-being support may help residents and other surgeons manage stress.