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To compare topical and subtenon anesthesia for clear corneal incision phacoemulsification

Poster Details

First Author: Y.Yilmaz TURKEY

Co Author(s):    G. Kaya              

Abstract Details



Purpose:

To compare the efficacy of topical and subtenon anesthesia for cataract extraction with intraocular lens implantation.

Setting:

Sultanbeyli State Hospital, Department of Ophthalmology

Methods:

72 patients were assigned to the topical (group 1; n = 37) and subtenon (group 2; n = 35) anesthesia groups by permuted block restricted randomization. Group 1 received topical 0.75% bupivacaine for anesthesia. Group 2 received subtenon with an equal mixture of 2% lidocaine and 0.75% bupivacaine plus hyaluronidase . A visual pain analogue scale was used to assess the degree of pain during the administration of anesthesia, during surgery, and post-operatively. The degree to which eye movement, touch, and light caused patient discomfort was assessed. Complications and surgical conditions were recorded.

Results:

There was no difference in the surgical conditions (P = 0.4) or pain during surgery (P = 0.32) between the two groups. There was more discomfort during administration of topical anesthesia (P < 0.002) and postoperatively (P < 0.05) in the topical group. Chemosis, subconjunctival hemorrhage, were seen almost exclusively in the subtenon group. One patient in group 2 had a massive subconjonctival hemorrhage . Although both group hadn t any bad resuls in terms of postoperative visual acuity .

Conclusions:

Topical anesthesia can be used safely for cataract extraction. The degree of patient discomfort is only marginally higher during administration of the anesthesia and postoperatively. However, surgical training and patient preparation are the keys to the safe use of topical anesthesia. FINANCIAL INTEREST: NONE

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