Abstract :
Aims: To assess the quality of analgesia, level of comfort of patients and surgeons and incidence
of complications after topical anaesthesia with supplemental intracameral lignocaine as compared to
peribulbar block in patients undergoing phacoemulsification.
Materials and Methods: It was a prospective observational study done in 66 patients having
uncomplicated senile cataracts who underwent phacoemulsification with foldable IOL implantation of
both eyes. One eye of each patient was operated under peribulbar blockand the other eye under topical
anaesthesia with supplemental intracameral lignocaine after 2 weeks. In Group T, topical anaesthesia was
achieved by instilling proparacaine hydrochloride 0.5% and preservative free 1% lignocaine was used for
intracameral analgesia. Peribulbar block was administered with 5-7 ml of 2% lignocaine with 1:10000
adrenaline. Patient comfort, feeling of pressure during block, quality of analgesia intraop and 4 hours
postop, and surgeon’s comfort were documented.
Results: Group P patients had significantly higher pain score, discomfort and pressure on eye during
administration of block compared to Group T. Both groups had comparable pain scores and patient’s
discomfort. Pressure on eye intraop and postop and intraoperative positive pressure were also similar in
both groups. Group P had significantly higher incidence of subconjunctival hemorrhage (80% vs 10%) and
chemosis of conjunctiva. (80% vs 0%).
Conclusion: Topical anaesthesia with supplemental intracameral lignocaine can be considered as a superior
anaesthetic technique for phacoemulsification than peribulbar block as it is associated with significantly
higher patient comfort and lower complications with comparable surgeon’s comfort.
Keyword :
Topical anaesthesia, Intracameral, Peribulbar anaesthesia, Phacoemulsification.