Comparison Of Two Techniques Of Topical Anaesthesia For Phacoemulsification.

To compare a modified technique of topical anaesthesia using a cotton wick soaked with proparacaine 4% eye drops placed in the inferolateral conjunctival fornix to the conventional technique of proparacaine 4% topical drops. The  surgeon comfort during surgery, patient compliance intra operatively and need for additional anaesthesia was compared.

The study was conducted in a tertiary care hospital, Father Muller medical college hospital in Mangalore city ,Karnataka,India.  

A triple blinded randomized study was conducted on patients who underwent phacoemulsification with IOL implantation in both eyes at different sittings.One eye received proparacaine 4% eye drops whereas for the other eye, a cotton wick soaked with proparacaine 4% eye drops is placed in the inferotemporal conjunctival fornix for 5 minutes prior to surgery.The intensity of pain was recorded by using Wong Baker pain scale, the need for additional intraoperative anesthesia,and the surgeon comfort was assessed. Investigator 1 administered the anaesthesia in the pre operative room and the surgeon was unaware of the mode of anaesthetic applied. Investigator 3 interviewd the patient and the surgeon regarding the intraoperative course.

50 patients were included in the study. There was significantly lower intensity of pain with the cotton wick anesthesia than with topical drops (p=0.027). Ease of surgery was also found to significantly better with wick Anaesthesia than with drops (p=<0.001). Number Of times additional anesthesia was required was higher in drops group with p value 0.012. Incidence of intra operative complications was similar in both the groups.

Topical anaesthesia with wick soaked in proparacaine is a simple and effective,  superior method for topical anesthesia for phacoemulsification in terms of both patient and surgeon comfort.It is effective and satisfactory even in cases where intra-operative complications are encountered.