Intraoperative aberrometry in cataract surgery with topical versus peribulbar anesthesia

To study the effect of choice of anesthesia on the refractive outcomes of intraoperative aberrometry (IA) for intraocular lens power calculation in cataract surgeries.

This prospective, interventional nonrandomized cohort study was conducted at a tertiary care hospital between March and August 2018. A total of 178 patients with age-related cataract were allocated into two groups. Group 1 received peribulbar anesthesia using a mixture of xylocaine 2% + adrenaline 0.125 mg/ml + hyaluronidase 15 IU/ml with a 23G, 32 mm needle, while Group 2 received topical anesthesia with proparacaine hydrochloride 0.05% drops. Intraoperative aphakic measurements and IOL power calculations were obtained in all patients with the optiwave refractive analysis (ORA) system. Analysis was performed to compare the baseline parameters and postoperative manifest refraction at month 1.

A total of 89 patients were included in group 1 and 89 in group 2. At baseline, the axial lengths (P = 0.66) and mean keratometry (P = 0.91) were comparable. The quality measure of captured wavefront data was comparable (0.25) between the groups. Also, the postoperative mean refractive spherical equivalents were comparable between the two groups (P = 0.98) at one month.

IA can be utilized well for cataract surgeries performed under local anesthesia with good quality of captured wavefront, provided the eye can be aligned in centre with the fixation light of ORA.