Clinical study of pain sensation during phacoemulsification with and without cryoanalgesia

Abstract

To compare the analgesic efficacy of 2 types of anesthetic techniques-topical and topical associated with cryoanalgesia-during cataract surgery. Department of Ophthalmology, University of São Paulo, Ribeirão Preto, Brazil. Prospective randomized study. Patients with symmetrical bilateral cataract had phacoemulsification with the use of an intraocular irrigation solution at room temperature in 1 eye and a cold (4°C) solution in the contralateral eye (Group 2). The pain related to the procedure was assessed using a visual analog scale ranging from 0 to 100, with 0 representing no pain and 100 the worst pain. In addition, endothelial cell loss, the change in corneal thickness, and visual acuity were evaluated 30 days ± 2 (SD) after each surgery. The surgery duration, total irrigation volume, phacoemulsification time, and ultrasound power used were analyzed. The study enrolled 25 patients (50 eyes). There was no statistically significant difference in the mean pain score between Group 1 (26.0 ± 3.7) and Group 2 (21.3 ± 3.6) (P = .2016, paired t test). No significant difference was found in the mean corneal endothelial cell loss (Group 1: 10.0% ± 0.4%; Group 2: 9.9% ± 0.3%; P = .7576), corneal thickness increase (Group 1: 1.5 ± 1.0 μm; Group 2: 1.4 ± 0.9 μm; P = .9340), or visual acuity gain (Group 1: 0.54 ± 0.06 logMAR; Group 2: 0.55 ± 0.09 logMAR; P = .8208). There is no difference in the intensity of pain during phacoemulsification with the use of topical anesthesia or topical anesthesia associated with cryoanalgesia. No author has a financial or proprietary interest in any material or method mentioned.