Comparison of clinical outcomes, patient, and surgeon satisfaction following topical versus peribulbar anesthesia for phacoemulsification and intraocular lens implantation: A randomized, controlled trial.
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Date
2014-09
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Abstract
Background: Both cataract surgery and anesthesia techniques are rapidly evolving to become more
patient friendly. However, comparison of topical anesthesia (TA) and peribulbar anesthesia (PA) for
phacoemulsification and cataract surgery is limited. We evaluated the clinical outcomes and patient and
surgeon satisfaction between anesthetic techniques. Materials and Methods: This randomized clinical trial
was conducted between January and June 2012. Patients were randomly assigned to TA and PA groups for
surgery. Visual acuity at 4 weeks postoperatively, status of the cornea and the wound and intraoperative
complications were compared between groups at day 1, and 1 and 4 weeks after surgery. Patients and
the surgeon completed a close‑ended questionnaire on satisfaction with analgesia and comfort. The
relative risk (RR) with 95% confidence intervals (CI) was calculated. Result: There were 500 patients in
each group. There were no significant differences between groups preoperatively. Complications at 1‑day
postoperatively were significantly greater in the TA group (RR = 1.36, 95% CI: 1.17–1.58). Satisfaction
with the mitigation of pain was statistically significantly greater in the PA group compared to the TA
group (χ2 = 10.9, df = 3, P = 0.001). Surgeons were more satisfied with PA compared to TA (RR = 1.4,
95% CI: 1.34–1.63). There were more anesthesia‑related complications in the PA group compared to the
TA group. Conclusions: Patients who underwent surgery with topical anesthetic experienced lower
complications by more pain compared to patients who underwent PA. Topical anesthetic supplemented
with analgesic medications could help the patient and surgeon during cataract surgery.
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Keywords
Anesthesia, cataract, phacoemulsification, randomized control trail
Citation
Dole Kuldeep, Kulkarni Sucheta, Shisode Kavita D, Deshpande Rahul, Kakade Rahul, Khandekar Rajiv, Deshpande Madan. Comparison of clinical outcomes, patient, and surgeon satisfaction following topical versus peribulbar anesthesia for phacoemulsification and intraocular lens implantation: A randomized, controlled trial. Indian Journal of Ophthalmology. 2014 Sept ; 62 (9): 927-930.