Comparing Retrobulbar and Topical Anaesthesia in Cataract Surgery by Phacoemulsification – How Can Patient Comfort During Surgery by Phacoemulsification Be Improved?

Abstract

The first section of this article is a summary of the development of cataract surgery and the anaesthetic methods used in cataract surgery. When comparing the effectiveness of retrobulbar anaesthesia (RBA) and topical anaesthesia (TA), we found that more patients in the TA group indicated pain during the procedure (p<0.001). After analysing pre-operative data, we could predict which patients would report intraoperative pain with 93% certainty. The type of anaesthesia and the skills of the surgeon are robust factors, while higher levels of stress hormones before surgery are also significant, especially in younger patients. The possible origin of pain and the role of positive verbal communication around the procedure are discussed. In order to prevent unexpected surgical situations, it is better to offer patients the most appropriate method of anaesthesia rather than using a ‘one size fits all’ solution.