Limbal anaesthesia versus topical anaesthesia for clear corneal phacoemulsification.
OBJECTIVE
To compare the safety and clinical efficacy provided by limbal anaesthesia with topical anaesthesia in cataract surgery.


METHODS
A total of 117 consecutive patients undergoing routine cataract surgery were randomly assigned to receive limbal or topical anaesthesia. Limbal anaesthesia was administered with a cellulose ophthalmic sponge soaked in preservative-free lidocaine hydrochloride 4% applied to the temporal perilimbal area for 45 seconds immediately before surgery. For topical anaesthesia lidocaine 4% was instilled in each patient at 10-min intervals four times before surgery. We studied phaco time, perioperative pain, visual outcome and intraoperative complications. The level of intraoperative pain was scored on a scale of 1-10, where 1 = no pain and 10 = severe pain.


RESULTS
55 patients (91.6%) in the topical group and 54 patients (94.7%) in the limbal group tolerated the procedure well, giving pain scores of 1-3, with no statistical difference. No patients in either group required supplemental anaesthesia and no intraoperative complications were recorded. No eyes had epithelial defects at the end of surgery or at postoperative check-ups.


CONCLUSIONS
Limbal anaesthesia in cataract surgery is safe and the two anaesthesia techniques do not present differences in the degree of analgesia achieved.
Cagini
Carlo
C
Department of Ophthalmology, University of Perugia, Perugia, Italy. carlocagini@hotmail.com
De Carolis
Alessandra
A
Fiore
Tito
T
Iaccheri
Barbara
B
Giordanelli
Antonella
A
Romanelli
Donatella
D
D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003315:Cornea / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D016850:Limbus Corneae; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011183:Postoperative Complications; D016896:Treatment Outcome; D014792:Visual Acuity
D000779:Anesthetics, Local; D008012:Lidocaine