Small-incision manual extracapsular cataract extraction using deep-topical, nerve-block anesthesia.
OBJECTIVE
To determine whether deep-topical anesthesia is suitable for small-incision manual extracapsular cataract extraction (ECCE).


METHODS
Three hundred twenty-six eyes of 253 patients had small-incision manual ECCE under topical anesthesia with a 4% lidocaine-soaked sponge. The severity of the pain, eye movements, blepharospasm, and intraoperative complications were recorded. Patient and surgeon satisfaction levels were assessed.


RESULTS
Operations on 323 eyes (99%) were completed with topical anesthesia. Intraoperatively, topical anesthesia was converted to peribulbar anesthesia in 3 eyes (0.9%) because of excessive eye movements. The cauterization of the scleral vessels and conjunctiva and the subconjunctival injection were the stages causing severe pain. The most frequent intraoperative complication was posterior capsule rupture in 6 eyes (1.8%). The satisfaction level was 95% for the patients and 90% for the surgeon.


CONCLUSIONS
Deep-topical, nerve-block anesthesia provides anesthesia with sufficient quality for small-incision manual ECCE.
Kaderli
Berkant
B
Department of Ophthalmology, Uludag University Hospital, Bursa, Turkey.
Avci
Remzi
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002387:Cataract Extraction / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D007910:Lenses, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009407:Nerve Block / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000473:pathology; D017060:Patient Satisfaction; D019904:Polymethyl Methacrylate
D000779:Anesthetics, Local; D019904:Polymethyl Methacrylate; D008012:Lidocaine