Peribulbar versus retrobulbar anaesthesia for cataract surgery

Area of Science:

• Ophthalmology
• Anesthesiology

Background:

• Cataract surgery, a common procedure to restore vision, typically utilizes local anesthesia.
• Retrobulbar and peribulbar blocks are the primary regional anesthesia techniques for ophthalmic procedures.
• A comparative analysis of these two anesthesia methods is crucial for optimizing patient outcomes and safety.

Purpose of the Study:

• To evaluate the efficacy and safety of peribulbar anesthesia versus retrobulbar anesthesia in cataract surgery.
• To compare pain perception, ocular akinesia, patient satisfaction, and complication rates between the two anesthetic techniques.

Main Methods:

• A systematic review of randomized controlled trials was conducted.
• Searches included the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE.
• Data on pain, akinesia, acceptability, and complications were extracted and analyzed.

Main Results:

• Six trials with 1438 participants were included, with varying risk of bias.
• No significant differences were found in pain scores or the need for additional anesthesia.
• Conjunctival chemosis was more frequent with peribulbar blocks, while lid hematomas were more common with retrobulbar blocks.

Conclusions:

• Peribulbar and retrobulbar blocks demonstrate comparable effectiveness and safety profiles for cataract surgery.
• Patient acceptability, akinesia, and the incidence of severe complications were similar between the two techniques.
• Both methods are largely safe, with severe complications being rare.