TOPICAL VERSUS PERIBULBAR ANESTHESIA IN CLEAR CORNEAL CATARACT-SURGERY

Purpose: To evaluate the efficacy of topical anesthesia as an alternat ive to peribulbar anesthesia in clear corneal cataract surgery. Settin g: Department of Ophthalmology, University of Vienna, Austria. Methods : In this prospective, double-blind clinical trial, 36 patients had bi lateral cataract surgeries performed from 1 to 3 months apart. Half of the patients had topical anesthesia for the first surgery and peribul bar anesthesia for the second surgery. The other half had peribulbar f irst and then topical, All surgery was done using a temporal clear cor neal approach and bimanual phacoemulsification followed by in-the-bag intraocular lens implantation. Subjective pain was assessed using a vi sual analog scale of no pain (0%) to worst pain imaginable (100%) and intraoperative motility using a rank scale of adverse motility (-5) to ideal patient cooperation (+5). Results: Subjective pain was comparab le whether topical or peribulbar anesthesia was used (mean 10.75 versu s 10.97%; P > .6). Patient cooperation (motility) was significantly be tter when topical anesthesia was used (+2.16 versus +1.11; P = .03). T here were no significant differences in complications. A peribulbar bl ock was given in addition to the topical anesthesia in two cases. Conc lusions: Topical anesthesia is a safe, effective alternative to peribu lbar anesthesia in clear corneal cataract surgery.