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Percaruncular single-injection anesthesia versus classic double-injection peribulbar anesthesia in cataract surgery: a prospective randomized study

Poster Details

First Author: W.Zbiba TUNISIA

Co Author(s):    I. Ammous   M. Korbi   E. Bouayed   A. Baba   J. Abid   O. Beltaief

Abstract Details


This prospective randomized single-center study was conducted to compare the percaruncular (also called medial canthus) single-injection anesthesia in cataract surgery, to the classic double-injection peribulbar technique.


Department of Ophthalmology, Mohamed Taher Maamouri Hospital Nabeul Tunisia


Ninety patients scheduled for cataract surgery were randomly assigned to either a single medial canthus injection or a double peribulbar injection. We injected both group an anesthetic mixture: Lidocaine 2 % with Adrenaline /Bupivacaine 0.5% /clonidine. Ocular and eyelid akinesia, amount of anesthetic agent injected, number of reinjections, the adequacy of anesthesia and complications were assessed after the procedure.


The percaruncular single-injection peribulbar anesthesia was significantly less painful (adequate anesthesia in 93.3% of cases) and required significantly less anesthetic agent than the double-injection peribulbar anesthesia(8.2±1.4ml versus 10.2±1.2ml). Akinesia-score, pain perception and the reinjection rate were similar in the 2 groups. There were no major anesthesia-related adverse events, only minor complications: chemosis (6.6 % for de percaruncular anesthesia versus 8.8% for the classic one) and spotting subcojonctival hemorrhage (6.6 % for de percaruncular anesthesia versus 4.4% for the classic one).


Percaruncular single-injection anesthesia is as much effective as the usual double-injection peribulbar anesthesia in cataract surgery. Although a reasonable percent of patients require a supplementary injection, yet this technique is easier to master, have broader indications, safer, less painful, uses less anesthetic agent than the classic peribulbar double-injection. The incidence of minor complications is in the accepted range. FINANCIAL INTEREST: NONE

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