Visual acuity immediately following phacoemulsification with subconjunctival anesthesia

The authors attempted to discover the quality of vision experienced immediately after cataract surgery by those patients receiving subconjunctival anesthesia and no postoperative patching. Eighty-five consecutive patients who underwent phacoemulsification were studied. Anesthesia was topical tetracaine followed by a subconjunctival injection of a lidocaine-bupivicaine hydrochloride-hyaluronidase mixture. Visual acuities were measured within a half hour after surgery and at 1 day postoperatively. Immediate postoperative visual acuities ranged from 20/25 to 20/200. Visual acuities were 20/40 or better in 14 patients (16.4%), 20/50 to 20/60 in 22 patients (23.5%), and 20/70 to 20/200 in 49 patients (60.1%). The early postoperative visual acuity measurements vary widely. There was a marked improvement at 1 day after surgery, with acuities becoming more aligned with expected outcomes.