[Sponge anesthesia with intraocular lidocaine application in cataract surgery]

For cataract surgery in this country retro- and peribulbar anesthesia is the standard method. It totally stops eye movement as well as sensitivity to pain. Especially peribulbar anesthesia is known as a procedure with minimal complications, but the potential risks can be severe. In the past sponge anesthesia could not be used on patients with difficult cataract surgery due to the insufficient anesthetic effect. A modified anesthetic method is demonstrated for complicated cataract surgery.

In 281 non-selected, successive phacoemulsifications, all performed by the same surgeon, we applied sponge anesthesia and 1.5 mg midazolam as premedication. Only in cases of moderate and severe sensitivity was 1% 0.15 ml lidocaine applied intraocularly. The intensity of sensitivity was graded as 1 for low, 2 moderate, and 3 severe.

Ninety eyes had complicated cataract surgery. Of the patients, 84.3% felt no pain during surgery; 11.4% were part of group 2 (moderate). Ten of 12 patients who had stated moderate sensitivity at first were free of pain after intraocular application of lidocaine, while the other 2 patients only felt minor sensitivity.

The anesthetic procedure we present offers a safe alternative method to surgeons who are able to do surgical procedures on a mobile eye.