TOPICAL ANESTHESIA FOR PHACOEMULSIFICATION SURGERY

Although phacoemulsification with only topical anaesthesia is possible , the level of any discomfort perceived by the patient is unknown. Top ical anaesthesia eliminates any risk of inadvertent ocular or orbital injury. Twenty-four patients undergoing phacoemulsification under only topical anaesthesia (g. amethocaine 1%) were compared with 23 patient s undergoing the same procedure with peribulbar anaesthesia (5 mi lign ocaine 2%, 5 mi bupivacaine 0.5% and 75 units hyaluronidase). Perceive d pain on administration of the anaesthesia, per-operatively and post- operatively was assessed by a nursing officer using a visual analogue scale (0-10). It was found that there was no difference in pain score between the two groups on induction of anaesthesia. Per-operatively an d post-operatively scores were higher in the topical group than in the peribulbar group (p < 0.05, Mann-Whitney U-test), though most of thes e were within the range 0-3, ('no pain' to 'slight pain'). There was n o difference in the amount of analgesia dispensed to the two groups on the ward post-operatively. In conclusion, topical anaesthesia provide s adequate anaesthesia for phacoemulsification, Although a small incre ase in the level of discomfort was observed, the pain levels reported were small and may not be clinically significant when set against the reduced incidence of anaesthetic-related complications.