20. Comparing Retrobulbar and Topical Anaesthesia in Cataract Surgery
Malik Jamil Ahmed1, Muhammad Nasir2 and Rida Arshad3
ABSTRACT
Objective: To evaluate and compare perioperative and anesthetic complication and surgeon satisfaction in retrobulbar injection of anesthetic agent and topical anesthesia for cataract surgery.
Study Design: Randomized Control Trial study.
Place and Duration of Study: This study was conducted at the Department of Anaesthesia and Ophthalmology Nishtar Hospital, Bakhtawar Amin Medical and Dental College Multan and Shahida Islam Medical College, Lodhran from April 2017 to April 2018.
Materials and Methods: Adult patients of age limit from 35 to 60 years who were selected for cataract surgery were included. Patients were divided into two groups with computer randomization system. Preoperative, post-operative complication pain score and surgeon satisfaction are main outcome variables. SPSS version was used to analyze data. P value ≤ 0.05 was considered as significant.
Results: Three hundred patients were included in this study of both genders. Capsular tear, zonular tear and vitreous loss for the patients who received topical anesthesiawas noted as n=3 (2%), n=7 (4.7%) and n=2 (1.3%) respectively. Chemosis, periorbital hematoma, subconjunctival hemorrhage and supplement periocular anesthesiafor the patients who received topical anesthesiawas observed as n=13 (8.7%), n=8 (5.3%), n=14 (9.3%) and n=19 (12.7%) respectively. Corneal edema, wound leak and IOP >30 mm Hgfor the patients who received topical anesthesiawas noted as n=2 (1.3%), n=4 (2.7%) and n=14 (9.3%) respectively. While, capsular tear, zonular tear and vitreous loss for the patients who received retrobulbar anesthesia was noted as n=6 (4%), n=7 (4.7%) and n=4 (2.7%) respectively. Chemosis, periorbital hematoma, subconjunctival hemorrhage and supplement periocular anesthesia for the patients who received retrobulbar anesthesia was observed as n=12 (8%), n=8 (5.3%), n=12 (8%) and n=4 (2.7%) respectively. Corneal edema, wound leak and IOP >30 mm Hg for the patients who received retrobulbar anesthesia was noted as n=2 (1.3%), n=7 (4.7%) and n=7 (4.7%) respectively. Supplement periocular anesthesia and IOP >30 mm Hg was statistically significant (p=0.000) and (p=0.000) respectively.
Conclusion: This study reveals that surgeon satisfaction is almost similar in both topical and retrobulbar anesthesia groups, pain score is slightly high in topical anesthesia but safety from complications in topical aesthesia is high as compare to retrobulbar group.
Key Words: Retrobulbar anesthesia, Topical Anaesthesia, Cataract Surgery, Pain score.
Citation of articles: Ahmed MJ, Nasir M, Arshad R. Comparing Retrobulbar and Topical Anaesthesia in Cataract Surgery. Med Forum 2018;29(7):78-81.