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Topical anesthesia in phacoemulsification: some steps beyond

Poster Details

First Author: R.Ionescu GREECE

Co Author(s):    K. Tsaousis   M. Dermenoudi   S. Dimitrakos   I. Tsinopoulos     

Abstract Details


To present two challenging cases of cataract operations (intraoperative video recordings) performed under topical anesthesia (eye drops) and to trigger further discussion about the optimum surgical management in demanding cases where general or even local anesthesia is not offered as alternative.


2nd Department of Ophthalmology, Aristotle University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, Greece


1st patient: 57 year-old male with history of excessive nystagmus associated with retinitis pigmentosa. Patient has uniform moderate nuclear cataract in both eyes. Best corrected visual acuity was perception of light in both eyes. 2nd patient: 75-year-old male, presented with reduced visual acuity in the left eye. Apart from advanced nuclear cataract in OS patient also had very poor pupil dilation. BCDVA: 4/10 OS and 8/10 OD. In both cases uncomplicated phacoemulsification performed under topical anesthesia along with intracameral Visthesia® (Carl Zeiss Meditec SAS, France) to enhance the analgesic effect.


Both our patients underwent uncomplicated phacoemulsification under topical anesthesia along with intracameral Visthesia® to enhance the analgesic effect. We selected to avoid general and local anesthesia due to general health problems that could induce a risk. The postoperative outcome was satisfactory in both cases with visual acuity significantly improved in the second patient. The first patient showed slight improvement as a result of compromised macula due to RP. The videos are presenting the modified technique that was applied in these cases in order to avoid intraoperative complications.


The assistance of general and local anaesthesia in modern phacoemulsification is valuable in certain cases such as poor patient cooperation. Topical anesthesia, which causes an almost non existing number of side effects is growing in popularity among cataract surgeons and these videos are an extreme demonstration of the wide range of scenarios that can be successfully managed without general or local anesthesia. This could be very helpful in cases where there is a relative or absolute contraindication of giving GA and/or LA. FINANCIAL DISCLOUSRE: NONE

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