English

Abstract

PURPOSE: To evaluate the patient and surgeons comfort for topical anesthesia as compared to peribulbar anesthesia for cataract surgery done by phacoemulsification. SETTING: Ophthalmology Department, Mahatma Gandhi Medical College & Hospital, Sitapura, Jaipur. METHOD: We had taken 120 patients age 40 years or more, both male & female with senile cataract attending our eye OPD of Mahatma Gandhi Medical Collage & Hospital, Jaipur. 120 patients who had undergone phacoemulsification were divided in two groups (Group A =60, Group B =60) randomly. 60 patients who had undergone surgery under topical anesthesia (Group A) were compared with another 60 patients who had undergone surgery under peribulbar anesthesia (Group B) by one doctor. Pain perception was assessed on administration of anesthesia and intraoperatively using a verbal pain score (0= no pain, 1= mild pain, 2= moderate pain, 3= severe pain which requires additional analgesia or increase the dose of local anesthesia). Patient and surgeons comfort was also assessed verbally. RESULT: The study used 120 eyes, 60 in each group A & B. Administration of topical anesthesia was significantly less painful and provides less discomfort then peribulbar anesthesia. Intraoperatively, feeling of pain and discomfort were slightly higher in topical anesthesia as compared to peribulbar anesthesia but this was not significant statistically. CONCLUSION: Cataract surgery done under topical anesthesia by phacoemulsification is thus considered safe and effective. FINANCIAL DISCLOSURE: No author has a financial or property interest in any material or method mentioned. INTRODUCTION: Good anesthesia is essential for the performance of safe intraocular surgery. Anesthesia for cataract surgery today aims at creating a comfortable environment for the patient and the surgeon during surgery and a quick recovery of function without Inherent added risks. Peribulbar injection of anesthetic agents has been used for more than a century in cataract surgery and various modifications have been devised over the last two decades to reduce the risks of injury of intraorbital structures during surgery. Topical anesthesia was first used in 1884 by Koller who used cocaine 1. After one century, Fichman used an attractive alternative method of injecting local anesthetic agents resulting in faster visual recovery and high patient satisfaction 1995 2 . Topical anesthesia has steadily gained popularity due to speed and ease of administration, rapid visual recovery postoperatively and the lack of block-related complications. Furthermore it is believed that patients feel less discomfort and pain.