title: Small-incision manual extracapsular cataract extraction using deep-topical, nerve-block anesthesia.
abstract: 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.
authors.affiliation: Department of Ophthalmology, Uludag University Hospital, Bursa, Turkey.
authors.forename: Berkant
authors.initials: B
authors.lastname: Kaderli
authors.forename: Remzi
authors.initials: R
authors.lastname: Avci
mesh_terms: 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
chemical_list: D000779:Anesthetics, Local; D019904:Polymethyl Methacrylate; D008012:Lidocaine