Topical anesthesia without intracameral lidocaine in cataract surgery.
OBJECTIVE
To evaluate the efficacy of topical anesthesia with oxybuprocaïne 0.4% without intracameral lidocaïne as an alternative to peribulbar or retrobulbar anesthesia in cataract surgery.


METHODS
Fifty-eight patients (eighty-two eyes) were included in this study. All patients received topical anesthesia with oxybuprocaïne 0.4%. No intracameral lidocaïne was used at the start of the intervention. Seventy-five per cent of patients received oral sedation with lorazepam 2.5 mg. All surgery was done using a superior corneal incision and phacoemulsification followed by a foldable IOL implantation. Subjective pain was assessed at 4 intervals during surgery using a 4-point pain scale. All patients were evaluated for intraoperative eye motility and blepharospasm. Patient and surgeon satisfaction was measured with a 4-point satisfaction scale.


RESULTS
15% of patients experienced mild pain during phaco and 43% had mild pain during corneal suturing. No patient had severe pain during the operation. In 4% of patients, intracameral lidocaïne was used to relieve pain. The surgeon and patient satisfaction was high. No eye movements or blepharospasm were recorded in 75% and 62% of cases respectively. No serious complications occurred.


CONCLUSIONS
Topical anesthesia is a safe and effective alternative to peribulbar and retrobulbar anesthesia in corneal cataract surgery for the experienced surgeon.
Spiritus
A
A
Huygens
M
M
Callebaut
F
F
D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001764:Blepharospasm / Q000517:prevention & control; D002387:Cataract Extraction / Q000379:methods*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007432:Intraoperative Period; D008012:Lidocaine; D008140:Lorazepam / Q000008:administration & dosage; D008875:Middle Aged; D010146:Pain / Q000517:prevention & control; D010147:Pain Measurement; D017060:Patient Satisfaction; D011343:Procaine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D011343:Procaine; D008012:Lidocaine; C005298:benoxinate; D008140:Lorazepam