Surgeon experience and patient comfort during clear corneal phacoemulsification under topical local anesthesia.
OBJECTIVE
To evaluate patient comfort during topical anesthesia clear corneal phacoemulsification surgery performed by a surgeon in the learning curve or by an experienced surgeon.


METHODS
Royal Alexandra Hospital, Paisley, Scotland, United Kingdom.


METHODS
This study comprised 46 consecutive patients having phacoemulsification under topical anesthesia of proparacaine 0.5% (Proxymetacaine. Surgery was performed by a surgeon during his learning curve (n = 20) or by an experienced surgeon (n = 26). No sedation or intracameral anesthesia was used in either group. All patients had clear corneal phacoemulsification with foldable acrylic posterior chamber intraocular lens implantation. Each patient's subjective experience of overall pain perioperatively (period immediately surrounding and during surgery) and worst pain perceived during surgery was measured immediately after surgery using a 10-point visual analog scale.


RESULTS
There was no significant difference in patient-reported pain scores for overall pain perioperatively (P =.47, Wilcoxon rank sum test) and the worst pain perceived during surgery (P =.32, Wilcoxon rank sum test).


CONCLUSIONS
Topical anesthesia with proparacaine provided similar and reasonable analgesic effects in patients having surgery by a surgeon in the learning curve and those having surgery by an experienced surgeon. The discomfort perceived during surgery performed by an experienced surgeon was less, although not statistically significantly different.
Mathew
Manu R K
MR
Argyll and Clyde Acute Hospitals NHS Trust, Renfrewshire, United Kingdom. prabha@tesco.net
Webb
Lennox A
LA
Hill
Robert
R
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D002983:Clinical Competence; D003315:Cornea / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000503:physiopathology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011430:Propoxycaine; D011446:Prospective Studies
D000779:Anesthetics, Local; C005717:proxymetacaine; D011430:Propoxycaine