Topical Anesthesia in High Volume Cataract Surgery: Pain Evaluation and Feasibility Study

Abstract

Context: This study was undertaken to evaluate the use of topical anesthesia for Manual small incision cataract surgery in high volume cataract surgery setup. Aims: The primary aim was to evaluate the pain experience of the patients undergoing Manual Small Incision Cataract Surgery (MSICS) under topical anesthesia using 2% lignocaine jelly in high volume cataract surgery setup. Secondary aims were to study any relation between the pain experience and education status, gender and age of the patients. Settings and Design: The study was an Interventional case series conducted at a tertiary care eye hospital. Methods and Material: Patients screened at the peripheral field camps were transported to base hospital and underwent MSICS under topical anesthesia using lignocaine 2% jelly and intracameral 0.5% lignocaine solution. Demographic data and pain experience of the patients during the surgery was recorded and analyzed. Statistical analysis: Statistical analysis was done using MedCalc® version 12.2.1.0 software for Windows 7. Descriptive analysis, Mann-Whitney test, Kruskal-Wallis test, and Spearman’s rho coefficient were used to analyze the data. Results: The study included 270 patients, with average age 62.7 years. Average pain score was 1.6 units (SD ± 0.72, scale 1-5) with ~85% patients reporting comfortable experience. Pain perception had no relation to gender, education status or age. Conclusions: Manual Small Incision Cataract Surgery under topical anesthesia using lignocaine 2% jelly and intracameral lignocaine, in high volume cataract surgeries safe and comfortable to majority of patients and is unaffected by gender, age or educational status of the patients.