title: Approaching a 100% success rate using topical anesthesia with mild intravenous sedation in phacoemulsification procedures.
abstract: OBJECTIVE
  Phacoemulsification with topical anesthesia has been accepted by some ophthalmologists as a minimally invasive alternative technique for cataract surgery. This study approaches a 100% success rate using topical anesthesia with mild intravenous (i.v.) sedation in phacoemulsification procedures.
  
  
  METHODS
  Two hundred consecutive patients underwent clear-corneal phacoemulsification. Patients were not preselected. Lidocaine hydrochloride topical anesthesia was supplemented with small-dose i.v. midazolam hydrochloride and/or fentanyl citrate. Patients underwent meticulous preoperative counseling. Those with dementia, deafness, movement disorders, or hyperanxiety, or those who spoke a foreign language or who were young required special management. Additional techniques were employed for ophthalmologic problems such as small pupil, mature cataract, and strong blink/Bell's phenomenon. Patient comfort was noted intraoperatively and postoperatively.
  
  
  RESULTS
  Ninety-seven percent of the patients did well, with only 3% requiring regional block or general anesthesia.
  
  
  CONCLUSIONS
  Using nucleofractis phacoemulsification with special techniques in more difficult situations, most patients were successful with topical anesthesia plus i.v. sedative anesthesia.
authors.affiliation: 19000 Hawthorne Blvd., suite 110, Torrance, CA 90503
authors.forename: S C
authors.initials: SC
authors.lastname: Dinsmore
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009883:Ophthalmic Solutions; D018918:Phacoemulsification / Q000379:methods*; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D018686:Anesthetics, Intravenous; D000779:Anesthetics, Local; D009883:Ophthalmic Solutions