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Topical versus peribulbar anesthesia, without sedation, for clear corneal phacoemulsification
R L Johnston1, L A Whitefield, J Giralt
1Moorfields Eye Hospital, London, England.
Journal of Cataract and Refractive Surgery
|April 29, 1998
Summary
Topical anesthesia is a safe and effective alternative to peribulbar anesthesia for clear corneal phacoemulsification, with comparable patient satisfaction despite minor perioperative discomfort.
Area of Science:
- Ophthalmology
- Anesthesiology
Background:
- Phacoemulsification is a common cataract surgery technique.
- Peribulbar anesthesia is a standard anesthetic approach.
- Topical anesthesia offers a less invasive alternative.
Purpose of the Study:
- To compare patient and surgeon acceptance of topical anesthesia versus peribulbar anesthesia for clear corneal phacoemulsification.
- To evaluate pain perception and satisfaction levels associated with each anesthetic method.
Main Methods:
- A comparative study involving 51 patients receiving topical amethocaine and 30 patients receiving peribulbar anesthesia (lignocaine and bupivacaine mixture).
- Pain was assessed using a visual analog scale (0-10) at three time points: anesthetic administration, perioperatively, and postoperatively.
- Patient and surgeon satisfaction was evaluated using questionnaires.
Main Results:
- Topical amethocaine administration was significantly less painful than peribulbar anesthesia (P = .03).
- No significant differences in perioperative or postoperative pain scores were observed between the groups.
- Patient satisfaction was high in both groups (67% topical vs. 73% peribulbar), with no surgical complications reported.
Conclusions:
- Topical anesthesia is a safe, effective, and well-tolerated option for clear corneal phacoemulsification.
- Despite a trend towards increased perioperative discomfort, topical anesthesia did not negatively impact overall patient satisfaction compared to peribulbar anesthesia.