Topical anesthesia versus peribulbar anesthesia in phacoemulsification cataract surgery and intraocular lens implantation

Abstract

Topical anesthesia during phacoemulsification cataract surgery has become the best choice for ophthalmologists, which broadens the indications for surgery, and eliminates the risk of peribulbar injections. The aim of our study is to assess the advantages and disadvantages, the efficacy and the tolerance of this protocol. Prospective study extending from January 2018 to December 2019, including 116 patients operated for cataracts under topical anesthesia (group 1), and 179 patients under peribulbar anesthesia (group 2). All patients were operated by phacoemulsification. The patients evaluated their pain on a visual analog scale graduated from 1 to 10. The two groups were comparable in age, gender and history of high blood pressure. All patients received premedication before surgery (Atarax). It was the first eye operated for cataracts in 79 patients in group 1 and 75 patients in group 2. The two groups did not differ significantly in systolic blood pressure rate (p= 0,36), pain score (p=0.54), duration of surgery (p=0.52), anaesthesia-related intraoperative difficulties (p=0.17), or intraoperative surgical complication rate (p=0.49) or blood oxygen saturation (p=0.74). However, in the peribulbar groups, better patient and surgeon satisfaction scores were obtained (P < .005).