Clinical Evaluation and Outcomes of Topical versus Retrobulbar Anesthesia in Cataract surgery by Phacoemelsification

Summary:

The objective of this study is to assess and compare the degrees of pain and problems experienced by patients undergoing phacoemulsification and implantation of foldable intraocular lenses. The study will specifically focus on patients with senile cataract who receive either topical or retrobulbar anaesthesia. An experimental study was conducted over a 10-month period at Al-Basir Ophthalmic Centre in Hawler, Iraq, using random assignment and control groups. We examined the eyes of 200 patients, totaling 200 in number. Phacoemulsification was performed on 100 eyes using retrobulbar anaesthesia, while another 100 eyes were treated with topical anaesthesia. The overall intra operative complication were capsular tear in 2.5%, zonular tear in 3.5% for, vitreous loss 2.5%, and iris prolapse occurred in 3% of patients. Chemosis was observed in 4% of the participants in the retrobulbar group, whereas none of the participants in the topical group exhibited chemosis. No significant disparity in intraoperative and early postoperative problems was detected. The retrobulbar group had a 4% incidence of subconjunctival haemorrhage and a 2% incidence of periorbital hematoma. Within the retrobulbar group, 92% of individuals reported a pain score of 0-1, whereas the remaining 8% reported a pain score of 2. Within the topical group, 80% of participants reported a pain score of 0-1, whereas the remaining 20% reported a pain score of 2. The topical approach achieved a patient satisfaction rate of 90%, while the retrobulbar procedure achieved a rate of 82%. There were no patients in either group who experienced a pain level of 3 (extremely severe intolerable pain). The incidence of surgical complications was comparable between the two anaesthesia procedures. Overall, topical anaesthesia provides a safe and efficient substitute for retrobulbar anaesthesia in cataract surgery that involves phacoemulsification and IOL folded lenses, particularly for proficient surgeons.

Keywords: Cataract, Surgery, Phacoemelsification, Anesthesia, Topical, Retrobulbar