Comparison Between Topical Anesthesia Versus Peribulbar Block Regarding The Rate Of Intraoperative Complications, Postoperative Patient Satisfaction And Visual Acuity In Cataract Surgeries With Multifocal Intraocular Lens Implantation

To compare topical anesthesia (TA) versus peribulbar block (PBB) regarding the rate of intraoperative complications, postoperative patient satisfaction and postoperative uncorrected visual acuity in cataract surgeries with multifocal intraocular lens (mIOL) implantation.

The type of anesthesia (TA or PBB) may interfere with the perception of dysphotopsia after cataract surgery with mIOL implantation, especially in the first hours after surgery, which may have impact on patient satisfaction. This is a retrospective study, evaluating medical records of 8,354 cataract surgeries performed between 2010 and 2025 in an ophthalmological medical center in Brazil.

Through a retrospective study, evaluating medical records of 8,354 cataract surgeries performed between 2010 and 2025, a cohort of 500 patients (1000 surgeries) undergoing mIOL implantation in both eyes were randomly distributed into 2 groups according to the type of anesthesia performed: 250 patients (500 surgeries) in the group with TA and 250 patients (500 surgeries) in the group with PBB. The two groups were compared in regard to the rate of intraoperative complications, postoperative patient satisfaction (scale from 0 to 10), postoperative uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA) at 24 hours, 1 month and 6 months postoperatively.

There was no statistically significant difference between the groups in regard to intraoperative complications, nor in relation to postoperative UDVA and UNVA in the time intervals evaluated in this study. There was no statistically significant difference between the groups in regard to patient satisfaction on 1 month and 6 months after surgery. Postoperative patient satisfaction was higher in the PBB group in the first 24-hours postoperative period compared to the TA group.(mean scale score: 8.8 in PBB versus 6.3 in TA; p<0.05)

According to this study, PBB appears to offer greater patient satisfaction in the first 24-hours postoperative period compared to TA in patients undergoing cataract surgery with mIOL implantation. This appears to be related to the greater complaints of dysphotopsia with TA in the first 24-hours after surgery, compared to PBB. There was no difference between TA and PBB in terms of UDVA, UNVA and patient satisfaction on 1 and 6 months after surgery.