Retrobulbar versus Subconjunctival Anaesthesia for Cataract Surgery – Experience in Nigeria

Abstract

Aim: To test the efficacy of subconjunctival anaesthesia (SCA) for cataract surgery against the established retrobulbar anaesthesia (RBA). Methods: This was a prospective study of 73 adults (44 males, 29 females) selected for cataract surgery and intraocular lens (IOL) implants under local anaesthesia. Their ages ranged from 24 years to 73 years. Thirty-seven (37) eyes had subconjunctival anaesthesia while 37 had retrobulbar anaesthesia for the cataract surgery and intraocular lens implant. The anaesthetic used was 2% lignocaine. An agreed marking scheme was formulated to assess the benefits of the anaesthesia and akinesia produced by the both methods. The anaesthesia (both methods) for all the patients was administered by one ophthalmologist and the assessment was done by the ophthalmologist and an assisting ophthalmologist. The results were collated and analysed according to the type of anaesthesia; any complications related to anaesthesia were noted. Results: Both SCA and RBA were satisfactory for cataract surgery. The RBA was observed to give better akinesia and less photophobia than the SCA during cataract surgery. There were no significant anaesthesia-related complications in either SCA or RBA. Conclusion: Subconjunctival anaesthesia is not as good as retrobulbar anaesthesia for cataract surgery in Nigeria because of observed less akinesia and more photophobia. There may be a need to give verbal instructions to the patients which they may not understand. Keywords: subconjunctival, retrobulbar, akinesia, anaesthesia, photophobiaNigerian Journal of Opthalmology Vol. 15 (2) 2007: pp. 52-56