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A comparison of patient pain and visual outcome using topical anesthesia versus regional anesthesia during cataract surgery

Authors Hosoda Y, Kuriyama S, Jingami Y, Hattori H, Hayashi H, Matsumoto M

Received 27 March 2016

Accepted for publication 23 April 2016

Published 20 June 2016 Volume 2016:10 Pages 1139—1144

DOI https://doi.org/10.2147/OPTH.S109360

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Yoshikatsu Hosoda, Shoji Kuriyama, Yoko Jingami, Hidetsugu Hattori, Hisako Hayashi, Miho Matsumoto

Department of Ophthalmology, Otsu Red-Cross Hospital, Otsu, Japan

Purpose: The purpose of this study was to compare the level of patient pain during the phacoemulsification and implantation of foldable intraocular lenses while under topical, intracameral, or sub-Tenon lidocaine.
Patients and methods: This was a retrospective study. Three hundred and one eyes subjected to cataract surgery were included in this study. All eyes underwent phacoemulsification surgery and intraocular lens implantation using topical, sub-Tenon, or intracameral anesthesia. The topical group received 4% lidocaine drops, and the intracameral group received a 0.1–0.2 cc infusion of 1% preservative-free lidocaine into the anterior chamber through the side port combined with topical drops of lidocaine. The sub-Tenon group received 2% lidocaine. Best-corrected visual acuity, corneal endothelial cell loss, and intraoperative pain level were evaluated. Pain level was assessed on a visual analog scale (range 0–2).
Results: There were no significant differences in visual outcome and corneal endothelial cell loss between the three groups. The mean pain score in the sub-Tenon group was significantly lower than that in the topical and intracameral groups (P=0.0009 and P=0.0055, respectively). In 250 eyes without high myopia (<-6D), there were no significant differences in mean pain score between the sub-Tenon and intracameral groups (P=0.1417). No additional anesthesia was required in all groups.
Conclusion: Intracameral lidocaine provides sufficient pain suppressive effects in eyes without high myopia, while sub-Tenon anesthesia is better for cataract surgery in eyes with high myopia.

Keywords: cataract, anesthesia, topical, intracameral, sub-Tenon

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