BackgroundTopical anesthetics have become the primary choice in phacoemulsification procedures for cataract extraction. The most common topical anesthetic drug used is 0.5% tetracaine eye drops. Repeated administration of 0.5% tetracaine drops can cause corneal epithelial damage. Two percent lidocaine gel is latest option which has longer contact time with corneal epithelium.ObjectivesTo compare the effectiveness of 2% lidocaine gel with 0.5% tetracaine drops in phacoemulsification surgery.MethodsThe study was a single blinded randomized clinical trial from March to July 2017 in patients underwent phacoemulsification cataract surgery. There were 72 subjects with age ≥ 40 years old who received randomization and divided into 2 groups: 2% lidocaine gel group and 0.5% tetracaine eye drop group. Topical anesthetics were applied 5 minutes before surgery. Five minutes after surgery, pain scale perceived during surgery was assessed by using a numerical rating scale. At the end of surgery, the subject filled the satisfaction questionnaire on topical anesthetic drugs administered. The ophthalmologists were also given a satisfactory questionnaire for topical anesthetic drugs selected for the procedure.ResultsThe median pain scale for 2% lidocaine gel group pain scale was 1; meanwhile, the median pain scale for 0.5% tetracaine eye drops was 3 (P < 0.05).ConclusionsTwo percent lidocaine gel was more effective in relieving pain during phacoemulsification cataract surgery compared with 0.5% tetracaine drops.
Background: To compare phacoemulsification (phaco) setting parameters with high (H) and low (L)parameters in Cipto Mangunkusumo (CM) hospitals impacted on corneal endothelial cell and patient’spain perception (PP) during phaco procedure.Methods: Forty eight outpatients were eligibly selected by RCT at CM hospital in periods ofNovember 2013 to April 2014. Impacts of setting parameter difference were observed by objectivemeasurement of endothelial cell density (ECD), central corneal thickness (CCT). The PP wasmeasured by a JCI approved standard using visual analog scale (VAS) were adapted. A built-insoftware for phaco US energy count which is cumulative dissipated energy (CDE) used to objectivelytimed the phaco time, duration of operation (DO) were timed, and standard visual acuity (VA) wasalso noted. Data analysis was performed using general linear model (GLM) repeated measures.Results: Increase of CCT and decrease of ECD after 1 month in high and low phaco parameter are notsignificantly different, respectively 0.23% vs 2.23% and 8.53% vs 6.99% (p>0.05). Significantdifference were found in CDE between H and L; 15.80 vs 21.29 (p=0.015). No statistically significantdifference of VAS nor DO and VA.Conclusion: High and low parameter phacoemulsifications have an equal result in safety and patient’scomfort. Keywords: setting phaco machine, endothelial cell density, central corneal thickness, visual analog scale
High myopia is a pathologic condition which has different anatomy from emmetropic eyes. The elongated vitreous chamber were increasing the shear stress of vitreous and retina, giving risk to several vitreoretinal disorders especially retinal detachment (RD). The extensive and complicated RD that happened in high myopic eyes make pars plana vitrectomy with silicon oil (SO) tamponade more preferable. Unfortunately, treatment of RD in high myopic eyes, especially with SO increase the incidence of cataract. The incidence of cataract in SO filled eyes is nearly 100% if the SO remains for several times. This paper reviews these issue, presenting the way to treat cataract in high myopic SO filled eye effectively with combination of phacoemulsification and SO removal with IOL implantation, helped with the usage of IOL Master. Â Keywords: phacoemulsification, high myopia, silicon filled eye
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