Topical versus peribulbar anaesthesia for cataract surgery

Abstract

ABSTRACT.Background: To assess and compare the efficacy and safety of topical versus peribulbar anaesthesia in patients undergoing routine cataract surgery. Methods: The unicentre, prospective, randomized, clinical interventional trial included 140 consecutive patients undergoing routine cataract surgery performed by one of two surgeons. The patients were randomly distributed to either peribulbar anaesthesia or topical anaesthesia. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale. Results: The study groups did not differ significantly in pain score (p = 0.54), duration of surgery (p = 0.52), anaesthesia-related intraoperative difficulties (p = 0.17), postoperative visual acuity (p = 0.94), overall intraoperative surgical complication rate, blood pressure rise (p = 0.16) or blood oxygen saturation (p = 0.74) Conclusions: Patient comfort and surgery-related complications did not differ between topical anaesthesia and peribulbar anaesthesia. As there are no significant differences between the two techniques in terms of subjective pain experienced by patients, intraoperative complications and postoperative visual outcome, and in view of the minimally invasive character of topical anaesthesia compared to peribulbar anaesthesia, the present study suggests the use of topical anaesthesia for routine cataract surgery.

Comparative clinical trial of topical anaesthetic agents for cataract surgery with phacoemulsification: lidocaine 2% drops, levobupivacaine 0.75% drops, and ropivacaine 1% drops

“…[8][9][10] Topical anaesthesia confers the advantages of relatively faster visual recovery and higher patient satisfaction, easy application, minimal discomfort on administration, rapid onset of anaesthesia, and lower cost. 5,[11][12][13] However, the use of a topical anaesthetic permits the patient's full ocular movement during surgery, requires patient compliance, and may involve the administration of supplemental anaesthesia. 5,12 Unpreserved lidocaine is the most frequently used and safest agent in topical anaesthesia.…”

“…5,[11][12][13] However, the use of a topical anaesthetic permits the patient's full ocular movement during surgery, requires patient compliance, and may involve the administration of supplemental anaesthesia. 5,12 Unpreserved lidocaine is the most frequently used and safest agent in topical anaesthesia. Because of the shortacting effect, intraoperative and/or postoperative pain, and dissatisfaction may be associated with the use of topical lidocaine.…”

“…It is now a widely accepted procedure and has become a wellestablished technique in phacoemulsification surgery as an alternative to the retrobulbar and peribulbar techniques. [2][3][4][5][6][7] Because it is less invasive, reducing the risk of complications and eliminating complications from needle and systemic toxicity, topical anaesthesia has gained popularity among surgeons. [8][9][10] Topical anaesthesia confers the advantages of relatively faster visual recovery and higher patient satisfaction, easy application, minimal discomfort on administration, rapid onset of anaesthesia, and lower cost.…”

Comparison of Topical Anesthesia With Peribulbar Anesthesia Small Incision Cataract Surgery

“…They also concluded that as topical anesthesia is less invasive than peribulbar anesthesia, patients may require less intraoperative and postoperative monitoring with topical anesthesia than with peribulbar anesthesia. 21 There was no difference in visual acuity in the two groups after six weeks. They reported that visual rehabilitation in the postoperative period is faster with topical anesthesia, as it allows patients to see just after surgery, whereas the optic nerve and extraocular muscles may still be partially blocked by local anesthetics in patients who have undergone cataract surgery with peribulbar anesthesia.…”

Trends in outpatient cataract surgery in the Islamic Republic of Iran, 2006-2010

“…Nevertheless, it is important that all conditions be evaluated prior to operation in older individuals with risk factors. Topical anaesthesia is very useful for outpatients and leads to fewer post-surgical complications (21), and previous studies have described the efficacy of topical anaesthesia in outpatient operations, even when performed by residents (22)(23)(24). Koolwijk et al (25) reported that outpatient cataract surgery is easy and safe with topical anaesthesia, with minimal complications.…”