Topical anesthesia for phacoemulsification and painless subconjunctival antibiotic injection

Endophthalmitis is a serious postoperative complication of phacoemulsificat ion surgery. Administration of a subconjunctival antibiotic is a common met hod of prophylaxis in the United Kingdom and other countries. Injection of subconjunctival cefuroxime can be very painful, especially after phacoemuls ification under topical anesthesia. Our experience is that this could be th e only painful step in the entire operation. We evaluated a technique in wh ich buffered lignocaine is injected into the subconjunctival space before t he antibiotic injection. The technique was used in 46 eyes (46 patients) th at had phacoemulsification under topical anesthesia. Eighty-seven percent o f patients found the injection painless, 6.5% reported that the pain was ve ry negligible, and 6.5% reported a moderate degree of pain. J Cataract Refr act Surg 2001; 27:198-200 (C) 2001 ASCRS and ESCRS.