RANDOMIZED TRIAL OF TOPICAL VERSUS SUB-TENONS LOCAL-ANESTHESIA FOR SMALL-INCISION CATARACT-SURGERY

Fifty unselected patients undergoing routine cataract surgery were ran domised to receive either topical or sub-Tenon's local anaesthesia wit h 2% prilocaine administered by a blunt cannula, Visual analogue scale s were used to assess pain during administration of sub-Tenon's anaest hetic and pain during surgery, and any complications were noted, Sub-T enon's anaesthesia proved to be entirely comfortable to administer, an d allowed for a statistically significantly more pain-free operation, at the expense of some residual eye movement and an inevitable subconj unctival haemorrhage, Both techniques compared well with other studies assessing periorbital or retro-orbital injections, and both have sign ificant safety advantages which are discussed in the context of the jo int Royal Colleges report on ophthalmic anaesthesia, It is suggested t hat a combination of one or other technique could safely cover all req uirements for intraocular surgery under local anaesthesia.