Efficacy of 2 Drops versus 3 Drops Proparacaine 0.5% Ophthalmic Solution for Phacoemulsification Surgery: A Comparative Study

Tanie Natung,Laura Amanda Lyngdoh,Avonuo Keditsu,Nilotpal Saikia,Jacqueline Syiem,Ranendra Hajong

doi:10.4236/ojoph.2015.53015

Abstract

Background and Aim: Phacoemulsification surgery with intraocular lens implantation is routinely done under topical anaesthesia in many centres. No comparative study on the efficacy of number of drops of topical anaesthetics effective for phacoemulsification surgery has been done. This study was conducted to compare the efficacy of 2 drops versus 3 drops proparacaine 0.5% ophthalmic solution for phacoemulsification surgery. Methods: Patients with uncomplicated cataract undergoing phacoemulsification surgery were randomised into two groups. Group 1 (n = 53) received 3 drops of proparacaine 0.5% whereas group 2 (n = 47) received 2 drops of the same solution before the start of surgery. All the patients underwent phacoemulsification with foldable intraocular lens implantation. Each patient’s subjective experience of pain was measured using a 10 point Visual Analogue Pain Scale (VAS). Patient’s cooperation during the surgery was assessed using a 3 point score. Both the evaluating resident doctor and patients were blinded. Results: In group 1, 73.6% patients scored 0, 20.8% scored 1 and 5.7% scored 2 of VAS respectively and in group 2, 89.4%, 6.4%, 4.3% patients scored 0, 1 and 2 of VAS respectively. In patient cooperation, 90.1% and 9.4% patients in group 1 scored 1 and 2 respectively whereas 87.2% and 12.8% patients scored 1 and 2 respectively in group 2. No statistically significant difference in the mean VAS (P = 0.0.55) and patient cooperation score (P = 0.597) was found between the two groups. The mean VAS score was 1.24 ± 0.534 and the mean patient cooperation score was 1.11 ± 0.314. The mean total surgical time was 25.11 ± 2.68 minutes. No additional drops were required for either group. Conclusions: Topical anaesthesia with both 2 drops and 3 drops proparacaine 0.5% ophthalmic solution is effective for phacoemulsification with intraocular lens implantation. Additional anaesthesia may be unnecessary in these cases.

Highlights

Clear corneal phacoemulsification with intraocular lens (IOL) implantation under topical anaesthesia is a standard practice today in many centres
Surgery under topical anesthesia may be rendered more difficult by repeated administration of topical medications which causes clouding of cornea [1]
A minimal number of drops of topical anaesthetic agents effective for phacoemulsification surgery will help in reducing the toxicity

Summary

Introduction

Clear corneal phacoemulsification with intraocular lens (IOL) implantation under topical anaesthesia is a standard practice today in many centres. A minimal number of drops of topical anaesthetic agents effective for phacoemulsification surgery will help in reducing the toxicity. Phacoemulsification surgery with intraocular lens implantation is routinely done under topical anaesthesia in many centres. No comparative study on the efficacy of number of drops of topical anaesthetics effective for phacoemulsification surgery has been done. Patient’s cooperation during the surgery was assessed using a 3 point score. Both the evaluating resident doctor and patients were blinded. No statistically significant difference in the mean VAS (P = 0.0.55) and patient cooperation score (P = 0.597) was found between the two groups. Conclusions: Topical anaesthesia with both 2 drops and 3 drops proparacaine 0.5% ophthalmic solution is effective for phacoemulsification with intraocular lens implantation.

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