Sub-tenon Anaesthesia versus Intracameral Anaesthesia in Patients Undergoing Cataract Extraction: A Comparative Study of the Level of Pain, Visual Perception and Anxiety

Abstract

Background: Phacoemulsification is a modern method of cataract extraction. Sub-tenon anaesthesia used to be the preferred anaesthetic technique for this procedure before intracameral anaesthesia gained its popularity in recent years. Nevertheless, many surgeons still believe that sub-tenon anaesthesia is better than topical anaesthesia. This study aimed to evaluate and compare the experiences of patients who were treated for cataract by phacoemulsification surgery using either sub-tenon or intracameral anaesthesia. Methods: Cross-sectional study conducted at Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. Participants were asked to complete a questionnaire within 1-2 hours following surgery. The questionnaires were designed to gather information on the patient’s level of anxiety, visual perception and amount of pain experienced during cataract surgery. Results: A total of 62 patients were included in the study. Thirty-one patients received anaesthesia by sub-tenon injection, whereas another 31 patients received anaesthesia by intracameral injection. There were no significant differences in the level of pain experienced by the two groups of patients during instillation of anaesthesia and during surgery (p=0.205 and p=0.592, respectively). There were also no significant differences in terms of visual perception and anxiety levels during surgery between the two groups (p=0.178 and p=0.731, respectively). Conclusion: Intracameral anaesthesia obviates the need for an injection during cataract surgery and is as comfortable for patients as sub-tenon anaesthesia in terms of visual perception, level of pain, and anxiety.

The Ideal Surgical Anaesthesia: A Comparison of Pain Experience in Subjects Undergoing Cataract Surgery Under Topical Versus Subtenon Anaesthesia

“…Numerous studies have been done worldwide showing favourable results for topical anaesthesia in cataract surgery. In Malaysia, a comparative study was performed for the level of pain, visual perception and anxiety in 62 patients given either subtenon or intracameral anaesthesia [3]. They found no significant differences in the level of pain experiences between the 2 groups of patients.…”

A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

“…However, other studies reported no significant differences in pain control between intracameral anesthesia and topical anesthesia. Mustapha et al 19 reported that intracameral anesthesia obviates the need for an injection during cataract surgery and is as comfortable for patients as sub-Tenon anesthesia in terms of visual perception, level of pain, and anxiety.…”