Topical Anaesthesia for Small Incision Cataract Surgery

Author(s):  
R. Bellucci
2021 ◽  
Vol 8 (37) ◽  
pp. 3328-3333
Author(s):  
Sumeet Deshpande ◽  
Rashmi R. Anwekar ◽  
Rajashree Reddy

BACKGROUND Anaesthesia is an integral part of any successful surgery. Advances in cataract surgery have led to changes in delivery of anaesthesia as well. Patient and surgeons’ comfort during anaesthesia and surgery is the single most important factor. In developing countries, small incision cataract is preferred sometimes over phacoemulsification in high volume centers. This study was done to compare patient and surgeon satisfaction following topical anaesthesia (TA) versus peribulbar anaesthesia (PA) for small incision cataract surgery (SICS) with intraocular lens implantation (IOL). METHODS This comparative observational study was done at M.R. Medical College, Kalaburagi over a period of 15 months from November 2018 to April 2020. 400 patients undergoing manual small incision cataract surgery (MSICS) after obtaining consent were included in the study, out of which 200 patients were administered TA while 200 were given PA randomly. Patients were prospectively evaluated for pain during administration, during surgery and 4-hours postoperatively through a questionnaire. RESULTS In our study TA group complained no pain whereas 85 % had mild pain and 13 % had moderate pain in PA group during administration of anaesthesia (P < 0.05). During surgery, none of the patients in both the groups experienced severe pain. 17 % patients in TA group had mild pain at 4 hours while only 4 % patients in PA group had pain (P < 0.05). There was no statistically significant difference in surgeon’s satisfaction between 2 groups. CONCLUSIONS Although the administration of PA is painful compared to TA, the patient satisfaction was more post-operatively in PA group. Topical anaesthesia has gained popularity due to minimal discomfort, speed of onset and lack of PA related complications. It is a safe and effective alternative to PA in MSICS with proper selection and education of patient. KEYWORDS Small Incision Cataract Surgery, Topical Anaesthesia, Peribulbar Anaesthesia


2011 ◽  
Vol 21 (6) ◽  
pp. 748-753 ◽  
Author(s):  
Swati V. Zawar ◽  
Parikshit Gogate

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.


2016 ◽  
pp. 47 ◽  
Author(s):  
Eugene Appenteng Osae ◽  
Angela Ofeibea Amedo ◽  
Kwadwo Amoah ◽  
Nana Yaa Koomson ◽  
David Kumah

2021 ◽  
Vol 7 (2) ◽  
pp. 419-421
Author(s):  
Madhuri P ◽  
Pooja H V ◽  
H T Venkate Gowda

To ascertain whether to stop or continue aspirin before cataract surgery. Prospective observational study from July 2018 to June 2019. Information on pre-existing medical conditions like cardiac disease/stroke & use of Aspirin was obtained from patients posted for cataract surgery. Physical examination was done by physician & decided whether aspirin has to be stopped before surgery. Intra-operative and post-operative outcomes were recorded. SPSS 20.0 by using descriptive statistics i.e. only frequency and percentage. Out of 64 patients, 38 discontinued aspirin and 26 continued. In the group of patients who discontinued aspirin, 2 had bleeding complication in the form of bleeding from cut ends of conjunctiva. Where as in the group who continued aspirin 4 patients had bleeding complication. No thromboembolic events were recorded in both the groups. The risk of medical & ophthalmic events surrounding cataract surgery were so low that absolute differences in risk associated with changes in Aspirin use were minimal.


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