Randomized Clinical Trial of Topical Versus Retrobulbur Anesthesia for Phacoemulsification: Comparison of Patient Satisfaction

Abstract

Purpose: Current anesthetic options for phacoemulsification typically include injection techniques, such as retro bulbar block, peribulbar block, sub-Tenon injection and topical anesthesia. Consensus does not yet exist on whether regional or topical anesthesia is the superior option, although topical anesthesia is being more commonly used.1

Material and Methods: This was a randomized clinical trail done at eye Operation theatre at Abbasi Shaheed Hospital Karachi. In group A topical anesthesia (TA), patients received a minimum total of 5 doses of 2% topical proparacaine. For performing retrobulbar (RBA) block in group B, patients received 2 % lidocaine anesthetic solution 1-2 ml into the retrobulbar space. Phacoemulsification was performed using clear corneal phacoemulsification and implantation of IOL. We used a scoring system, the lowa satisfaction with Anesthesia scale (ISAS) a self administered written questionnaire for assessment of patient satisfaction.

Results: Mean lowa score in topical group was 2.71 while it was 2.3 in retrobulbar group. Median lowa score in topical group was 3 while it was 2.54 in retrobulbar group. The difference in mean lowa score was found to be statistically significant between two groups (p value < 0.05).

Conclusions: Topical anesthesia (TA) is a safe, satisfactory alternative to retrobulbar (RBA) anesthesia without causing discomfort to the patients.