A Comparative Study of Topical Versus Peribulbar Anaesthesia in Phacoemulsification Cataract Surgery and Implantation of Intraocular Lens

Abstract

Introduction: This study was conducted for evaluating and comparing levels of patient discomfort during phacoemulsification and intraocular lens implantation under topical and peribulbar anesthesia and comparative assessment of intra-operative complications. Methods: It is a hospital based comparative study on patients who underwent phacoemulsification from January'2015 to March'2015. Patients were randomly distributed to peribulbar or topical anesthesia. Parameters like age, surgery duration, blood pressure, oxygen saturation and intraoperative pain were compared in two groups. Results: 51 patients underwent phacoemulsification under topical anesthesia and 49 patients underwent phacoemulsification under peribulbar anesthesia. No statistical differences were found in surgery duration, intra-operative complications, pain, blood pressure or Oxygen saturation (SPO2). Topical group did not require additional subconjunctival injection. 4/49 (8.16%) in peribulbar group required additional topical anesthesia. This was statistically significant (p=0.04). Anesthesia related complications were only seen in peribulbar group. Conclusion: Surgical complications and patient comfort did not differ in two groups. There is no significant difference in topical and peribulbar anesthesia with respect to intra-operative pain level and intra-operative complications. Also topical anesthesia is minimally invasive. In view of results obtained, study suggests usefulness of topical anesthesia as compared to peribulbar anesthesia for cataract surgeries.

A comparative study of clinical outcome following topical versus peribulbar anesthesia in phacoemulsification surgery

“…Peribulbar anesthesia being blind insertion of needle in retrobulbar space associated with few sight and few life threatening complications. 7 Topical anesthesia(TA), being noninvasive procedure, is believed to have advantages over peribulbar anesthesia(PA) in terms of safety, pain free, rapid onset and recovery, free of injection related complications, 7 rapid visual recoverybut it also has disadvantages of increase anxiety, discomfort and inadvertent eye movements for both patient and surgeon. 8 Many studies have been done to compare peribulbar and topical anesthesia, but being a government teaching institute catering to much of rural population, patients being excessively anxious, comparatively uncooperative, exhibit suboptimal cognition, cataract surgeries were always done under peribulbar anesthesia for all.…”