[Topical versus contact anaesthesia in conventional trabeculectomy. Prospective randomised study]

To compare the pain rates, comfort levels and safety between conventional topical anaesthesia and the application of a long lasting lidocaine soaked film or contact anaesthesia.

Fifty patients undergoing conventional trabeculectomy with or without Mitomycin-C were included. One half received topical anaesthesia and the other half contact anaesthesia in a random fashion. Pain and discomfort rates before, during and after surgery were evaluated on a scale from 0 to 5, also, surgeon subjective stress and complications observed were included in the clinical protocol.

Significant differences were found between both groups regarding pain rates, during and after surgery, and surgeon stress level. Sedation and change of anesthesic method were required more frequently by the patients included in the topical anaesthesia group.

Topical anaesthesia provides sufficient level of anaesthesia for performing a trabeculectomy. Nevertheless pain rate differences between contact and conventional topical anaesthesia were patent during and after surgery. Contact anaesthesia appears to be a valid and practical alternative in a wide range of patients undergoing glaucoma surgery.