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Visual perception during phacoemulsification cataract surgery under topical and regional anaesthesia
Paris G Tranos1, Sanjeewa S Wickremasinghe, Neil Sinclair
1Department of Ophthalmology, Royal Free Hampstead NHS Trust, London, UK. ptranos@hotmail.com
Acta Ophthalmologica Scandinavica
|May 20, 2003
Summary
Topical anesthesia for cataract surgery resulted in brighter light perception and more color visualization compared to regional anesthesia. Most patients found the visual experience non-frightening, regardless of anesthetic method.
Area of Science:
- Ophthalmology
- Anesthesiology
Background:
- Cataract surgery, including phacoemulsification and intraocular lens (IOL) implantation, is commonly performed under local anesthesia.
- Patient's subjective visual experience during surgery can impact their overall satisfaction and anxiety levels.
Purpose of the Study:
- To compare the subjective visual experiences of patients undergoing phacoemulsification and IOL implantation under different local anesthesia techniques: topical anesthesia (TA), sub-Tenon's anesthesia (SA), and peribulbar anesthesia (PA).
Main Methods:
- A prospective, questionnaire-based cohort study involving 247 patients undergoing routine cataract surgery.
- Patients received either TA, SA, or PA.
- A standardized questionnaire assessed intraoperative visual experiences immediately after surgery.
Main Results:
- No significant difference in light perception was observed across the three anesthesia groups.
- Topical anesthesia (TA) was associated with significantly brighter light intensity perception (78.3%) and greater color visualization (69.6%) compared to SA and PA (p=0.02 for both).
- Awareness of surgical instruments was higher in the TA group (26.1%) than SA (10.8%) and PA (15.9%), though not statistically significant (p=0.08).
Conclusions:
- Patients experience diverse visual sensations during cataract surgery under local anesthesia.
- Differences in visual experiences may be attributed to varying degrees of optic nerve blockade produced by different anesthetic methods.
- The visual experience was generally non-frightening across all groups, with a trend towards reduced anxiety in patients with prior cataract surgery.