Preferred Surgical and Anesthesia Techniques for Cataract Surgery in Jordan

Abstract

Purpose To study the current practices in Jordan regarding cataract surgical procedures and anesthesia trends for cataract surgery. Methods A cross-sectional survey of members of the Jordanian Ophthalmology Society was conducted in October 2020. The questionnaire included questions about participants’ demographics, the preferred surgical techniques for cataracts, the preferred anesthesia technique for cataract surgery, the factors which affect the choice of anesthesia technique, the use of sedation, who gives the anesthesia, if there is an anesthesia-trained person who observes the patient during cataract surgery, and the changing trends towards anesthesia between the surgeons. Results More than half of the respondents (59.1%) had been in practice for more than 5 years. The preferred method for routine cataract was phacoemulsification for most participants (98.4%). For mature cataract, phacoemulsification was the preferred method for 61.4% of participants. More than half (55.1%) used topical with intracameral anesthesia for phacoemulsification. Two thirds of the participants (66.3%) performed retrobulbar anesthesia for extracapsular cataract surgery. In the majority of cases (86.6%), the respondent themself is the one who administers the anesthesia. No sedation was used before surgery in 62.6% of cases. Two thirds of the respondents (70.1%) reported that they had an anesthesia-trained person monitoring the patient during surgery. Patient cooperation was the most important factor (70.9%) affecting the surgeon’s choice of anesthesia technique followed by surgeon skill and experience (57.5%). Conclusion Presently, phacoemulsification is the preferred surgical technique for cataract in Jordan. Topical with intracameral anesthesia is the most common anesthesia for phacoemulsification while retrobulbar anesthesia is the most common for extracapsular cataract extraction.

Anesthesia techniques and the risk of complications as reflected in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO).

“…The increasing popularity of topical anesthesia aligns with recent studies from other parts of the world where it was used in 55.1%, 64%, 69%, and 95.5% of cataract surgeries. [12][13][14][15] In a recent worldwide survey, Rossi et al also showed that topical anesthesia was used in >90% of routine cases in 81% of responding countries. 16 Likewise, in the United States, there has been an increasing trend for topical anesthesia from 8% in 1995 to 51% in 2000 and 61% in 2003.…”

Royal College of Ophthalmologists' National Ophthalmology Database study of cataract surgery: report 11, techniques and complications of local anesthesia for cataract surgery in the United Kingdom

“…Similarly, elsewhere across the globe, topical anesthesia with or without intracameral injection is the preferred anesthetic technique for phacoemulsification surgery. [9][10][11][12] Systematic reviews and meta-analyses have shown a better safety profile for topical and intracameral anesthesia compared with needle-based anesthetic techniques. Topical anesthesia also has a wider acceptability to patients and requiring less time for administration.…”

The Royal College of Ophthalmologists’ National Ophthalmology Database Study of Cataract Surgery: report 11, Techniques and Complications of Local Anaesthesia

“…Similarly, elsewhere across the globe, topical anaesthesia with or without intracameral injection is the preferred anaesthetic technique for phacoemulsi cation surgery. [9][10][11][12] Systematic reviews and meta-analyses have shown a better safety pro le for topical and intracameral anaesthesia compared to needle-based anaesthetic techniques. Topical anaesthesia also has a wider acceptability to patients, as well as requiring less time for administration.…”