IS EYE PADDING ROUTINELY NECESSARY AFTER UNCOMPLICATED PHACOEMULSIFICATION

Purpose To investigate the value of eye padding following uncomplicate d phacoemulsification under peribulbar anaesthesia. Methods A prospect ive randomised controlled study was conducted to compare the effect of a conventional eye pad and shield with that of a clear eye shield app lied without a pad in 83 patients undergoing routine phacoemulsificati on under peribulbar anaesthesia without lid block. The primary outcome measures were corneal fluorescein staining, discomfort, diplopia and mobility. Results Moderate or severe corneal fluorescein staining on t he first post-operative day was significantly more common in the pad a nd shield group (39%) than in the clear shield group (19%) (p < 0.01). There was no significant difference in post-operative pain as measure d either by visual analogue scale or by categorical pain scale. Forty per cent of the clear shield group reported transient postoperative di plopia during the immediate postoperative period compared with 7% of t he pad and shield group (p < 0.001). There was no significant differen ce in reported mobility between the two groups. Conclusions Following phacoemulsification under peribulbar anaesthesia, the use of a gauze e ye pad is associated with greater corneal fluorescein staining than a clear plastic shield without pad and offers no reduction in discomfort . A clear shield protects the globe against direct trauma, is associat ed with reduced moderate to severe corneal staining and facilitates vi sion in the early postoperative period. Transient diplopia reported by some patients given a clear shield is not disabling and would not be expected to occur in patients with one seeing eye. The use of a clear shield alone is a safe alternative to eye padding and offers important advantages in patients with one seeing eye.