A randomized clinical trial by Guerrier et al1 in this issue of JAMA Ophthalmology evaluates music as a nonpharmaceutical intervention for managing preoperative and intraoperative anxiety during cataract surgery. Possible interventions included either headphones with music or noise-canceling headphones with no music for 20 minutes in the preoperative area. The authors1 concluded that music reduced patient-reported anxiety, as well as hypertension, tachycardia, and the requirement for anxiolytic medication intraoperatively. The authors1 are to be congratulated on this valuable contribution to the literature, because anxiety surrounding cataract surgery is very common.2 However, a major limitation of the study design is in the masking of the study participants.1 Patients were informed of the possible interventions during the consent process and therefore knew which arm they were randomized to.1
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Schallhorn JM, Rose-Nussbaumer J. Masking Is Not Just for COVID-19. JAMA Ophthalmol. 2021;139(9):1013–1014. doi:10.1001/jamaophthalmol.2021.2706
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