Light sensitivity and pain sensation during cataract surgery. A comparative study of two modes of anaesthesia

Abstract

The objective of this study was to compare the light sensitivity and pain experienced by patients undergoing cataract surgery under subtenon and topical with intracameral anaesthesia. Fifty-four patients were randomly assigned to receive either two drops of proxymethacaine 0.5% as topical anaesthesia with 0.5 ml preservative-free 1% intracameral lidocaine or 4 ml 2% lignocaine as subtenon anaesthesia. Light sensitivity and overall pain perception were recorded at the end of surgery. The mean pain score in the subtenon group (0.11; range 0-1) was lower than in the topical group (1.07; range: 0-3, P < 0.001). The mean light-sensitivity score was lower in the subtenon group (0.26; range: 0-4) than in the topical group (1.29; range: 0-4, P = 0.001). Subtenon anaesthesia was more effective in suppressing light sensitivity and pain during cataract surgery than topical with intracameral anaesthesia. This suggests that use of subtenon anaesthesia may lead to a more comfortable operative experience.

Comparison between Subjective Sensations during First and Second Phacoemulsification Eye Surgeries in Patients with Bilateral Cataract

“…Some studies have also reported that patients can see instruments and movement within their visual field during surgery, and in some cases, where vision is lost completely during surgery, light sensitivity was still present for each patient [ 22 – 24 ]. High light sensitivity accompanying photophobia symptoms following cataract surgery can result in increased psychological distress for some patients [ 17 ]. This could in turn influence their intraoperative pain perception.…”

“…However, our analysis found that the differences in light sensitivity score between the two surgeries were not statistically significant. Different methods of anesthesia can affect the severity of light sensitivity [ 17 ], and the conditions for use of topical anesthesia for the patients included in our study were identical. We suggest that this is why the light sensitivity scores for the two operations were not significantly different.…”

“…Anxiety scores were graded using the Amsterdam preoperative anxiety and information scale (APAIS) [ 16 ]. Eye bulges scores reflected the intraocular perfusion pressure (0 = no, 1 = minimal, 2 = mild, 3 = moderate, and 4 = severe), and microscope light sensitivity was measured and scored (0 = no, 1 = minimal, 2 = mild, 3 = moderate, and 4 = severe) [ 17 ]. Patients were instructed to select a single number that best represented the level of each subjective sensation that they were experiencing.…”

<p>Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures</p>

“…Most importantly, patients experience greater discomfort during surgery. 13,14 It can also potentially have an impact on the incidence of intraoperative adverse events in noncompliant patients. 13,14 In private cataract surgery or refractive lens exchange, great emphasis is placed on patient's journey, experience and comfort.…”

“…13,14 It can also potentially have an impact on the incidence of intraoperative adverse events in noncompliant patients. 13,14 In private cataract surgery or refractive lens exchange, great emphasis is placed on patient's journey, experience and comfort. Additionally, many surgeons in our practice indicated that the surgery is technically easier if akinesia is achieved with local anesthesia, which is the reason why sub-Tenon's anesthesia with mild sedation is the main technique in our clinical practice.…”