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  • Title: Topical anesthesia without intracameral lidocaine in cataract surgery.
    Author: Spiritus A, Huygens M, Callebaut F.
    Journal: Bull Soc Belge Ophtalmol; 2000; 275():9-13. PubMed ID: 10853302.
    Abstract:
    PURPOSE: To evaluate the efficacy of topical anesthesia with oxybuprocaïne 0.4% without intracameral lidocaïne as an alternative to peribulbar or retrobulbar anesthesia in cataract surgery. METHODS: Fifty-eight patients (eighty-two eyes) were included in this study. All patients received topical anesthesia with oxybuprocaïne 0.4%. No intracameral lidocaïne was used at the start of the intervention. Seventy-five per cent of patients received oral sedation with lorazepam 2.5 mg. All surgery was done using a superior corneal incision and phacoemulsification followed by a foldable IOL implantation. Subjective pain was assessed at 4 intervals during surgery using a 4-point pain scale. All patients were evaluated for intraoperative eye motility and blepharospasm. Patient and surgeon satisfaction was measured with a 4-point satisfaction scale. RESULTS: 15% of patients experienced mild pain during phaco and 43% had mild pain during corneal suturing. No patient had severe pain during the operation. In 4% of patients, intracameral lidocaïne was used to relieve pain. The surgeon and patient satisfaction was high. No eye movements or blepharospasm were recorded in 75% and 62% of cases respectively. No serious complications occurred. CONCLUSION: Topical anesthesia is a safe and effective alternative to peribulbar and retrobulbar anesthesia in corneal cataract surgery for the experienced surgeon.
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