Perilimbal topical anesthesia for clear corneal phacoemulsification

Purpose: To evaluate the efficacy of perilimbal topical anesthesia for clea r corneal cataract surgery. Setting: Department of Ophthalmology, University of Udine, Udine, Italy. Methods: Seventy-five consecutive patients were studied for perioperative p ain, visual outcome, and intraoperative complications. Topical anesthesia w as administered with a cellulose sponge soaked in preservative-free lidocai ne 2%. The perilimbal area was touched 360 degrees for 30 seconds with the sponge tip under the operating microscope just before surgery. No sedation or adjunctive anesthetic drops were given. Surgery was performed through a temporal corneal tunnel with the easy-chop technique. Pain was scored on a subjective scale from 0 (no pain) to 3 (severe pain). Visual acuity was mea sured 1 day and 1 week after surgery. Mean operating time was recorded. Results: Sixty-nine patients (92%) tolerated the procedure well, giving a p ain score of 0 or 1. Six (8%) of the 40 patients who had a single stitch at the end of surgery scored 2. No patient reported pain during iris touch, i ntraocular lens implantation. or conjunctiva manipulation. No intraoperativ e complications were recorded. Mean operating time was 12.7 minutes +/- 3.7 (SD) (range 7 to 34 minutes). Mean preoperative visual acuity was 0.4 +/- 0.2 (range 0.01 to 0.80). Visual acuity of 0.5 or better was attained in 93 .6% of eyes 1 day and in 96% 1 week postoperatively. Conclusion: Perilimbal topical anesthesia was an effective and easy-to-admi nister anesthetic procedure for phacoemulsification, providing good periope rative pain tolerance by patients and rapid visual recovery. J Cataract Ref ract Surg 2000; 26:1642-1646 (C) 2000 ASCRS and ESCRS.