Phacoemulsification under topical anesthesia alone versus topical anesthesia with intracameral lodocaine injection

Abstract

Purpose: goal was to study the intra-operative pain experienced by patients when topical alone was used compared with topical anesthesia with intracameral lidocaine injection. To study the patient and surgeon satisfaction when the two different types of anesthesia are used. Setting/Venue: Regional Institute of Medical Sciences, Imphal, India. Methods: 40 patients of cataract divided into two groups, A and B each containing 20 patients were included in the study. phacoemulsification was performed on group A under topical anesthesia with proparacaine hydrochloride 0.5% and on group B under topical anesthesia along with intracameral infiltration of 2% lidocaine. Un co-operative patients, those with previous ocular trauma and corneal opacities were excluded from the study. All patients in both groups were operated by the same surgeon. The surgeon and patient satisfaction score was entered in a standardized proforma. Results: 6 patients in group A felt no pain while 3 patients felt pain upto the extent that 0.5 cc of 2% lidocaine was needed to infiltrate at the phaco port site. Thereafter the procedure was competed comfortably and pain free. Mean phacoemulsification time was 2.5 minutes and mean operation time was 30 minutes. In group B, the patients were operated after infiltration of 0.5 cc 2% lidocaine injection. 16 patients were operated pain free and 4 patients had mild pain. The mean phacoemulsification time was 2.2 minutes and the mean operation time was 30 minutes Conclusions: The intracameral infiltration of 2% lidocaine injection with topical anesthesia is superior to topical anesthesia with proparacaine hydrochloride alone during phacoemulsification ensuring patients and surgeons comfort. None of the patients in any group showed the complication as sometimes seen in periocular and retrobulbar anesthesia