Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery

Guay, Joanne; Sales, Karl

doi:10.1002/14651858.cd006291.pub3

Cited by 32 publications

(26 citation statements)

References 45 publications

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“…These agents provide sufficient anaesthesia to carry out these procedures under comfortable circumstances both for the patient and the doctor 1 . Topical anaesthesia has largely replaced other techniques of local anesthesia like retrobulbar/peribulbar anaesthesia being employed during cataract extraction via phacoemulsification [5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

Irshad¹

2019

pak J Ophthalmol

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Purpose: To determine the risk of ocular infections due to topical multi-dose anaesthetic eye drops in patients one month after opening the bottle. Study Design: Quasi experimental study. Place and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018. Materials and Methods: In this study topical anaesthetic eye drops containing proparacaine hydrochloride 0.5% as main ingredient and benzalkonium choride as preservative (Alcaine�) were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria. Patients who already had keratitis, conjunctivitis, corneal opacities, thin corneas and having dry eyes which were prone to get infected were excluded from this study. Results: There were 60 patients included in our study and they were divided in two groups. Group A included those who presented in the outdoor department and group B comprised of those admitted for various operative procedures. There were 30 patients in each group. All patients were adults (18-60 years). After 1 month of daily culturing on agar plates, no micro-organism growth was seen in both groups. Conclusion: Topical anaesthetic eye drops can be used safely for 1 month in different patients after opening the bottle without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis. Keywords: Proparacaine, Culture medium, Endophthalmitis.

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Section: Discussionmentioning

confidence: 99%

To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

Irshad¹

2019

pak J Ophthalmol

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“…Surprisingly, there are no randomised control trials comparing akinesia in subtenons with that in topical anaesthetic for cataract surgery. Intraoperative pain, on the other hand, is well established to be higher in topical anaesthetic than sub-tenons and may contribute to unwanted head and eye movements [27].…”

Section: Discussionmentioning

confidence: 99%

Intraoperative head drift and eye movement: two under addressed challenges during cataract surgery

Brogan

Dawar

Lockington

et al. 2018

Eye

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“…In a Cochrane database systematic review on sub-Tenon's versus topical anaesthesia for cataract surgery for cataract surgery, Guay and Sales [16] included seven studies on 742 operated eyes of 617 participants., Topical anaesthesia (with or without intracameral injection) for cataract surgery increases intraoperative pain but decreases postoperative pain at 24 hours when compared with subTenon's anaesthesia. The amplitude of the effect although statistically significant, was probably too small to be of clinical relevance.…”

Section: Sub-tenon's Anaesthesiamentioning

confidence: 99%

Local Anaesthesia in Cataract Surgery

Reddy

Thevi

2017

International Journal of Ophthalmic Research

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nerves of the cornea and the conjunctiva (long and short ciliary nerves, nasociliary nerves). This technique eliminates the possible complications of injectable anesthesia. However, it does not eliminate pain sensitivity of the iris, the zonule, and the ciliary body which is achieved by intracameral technique of anesthesia with preservative free 1% lidocaine. In a constantly evolving arena, the sub-Tenon's block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but there is a possibility of getting an allergic reaction. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. INTRODUCTIONThe ideal anaesthesia would be one that provides adequate pain relief during surgery and postoepratively, be easy to administer and have minimal complications. For doing cataract surgery, the anaesthesia could be local or general. Majority of cataract patients are operated under local anaesthesia (infiltration, topical, intracameral). The infiltration anaesthesia is given as retrobulbar or peribulbar or subTenon's block. Carl Koller first used cocaine as a topical anaesthetic for eye surgery in 1884 [1] . The general anaesthesia has its own complications in elderly cataract patients and most of them may have diabetes or hypertension or heart diseases or combination of them. No need of fasting before or after surgery, no need of intubation, no need of using any systemic medications are the advantages of local anaesthesia. However, cataract in children, patients with parkinsonism, deaf mute patients, mental retardation patients, patients ABSTRACTThere has been a significant evolution in surgical technique of cataract extraction. The technical advances in phaco machines, phacotips, and availability of ophthalmic viscoelastic devices have played a great role in cataract surgery to be faster and more controlled now than before. Similarly, local anesthesia techniques in cataract surgery have also advanced significantly from retrobulbar, peribulbar, sub-Tenon's, to topical anaesthesia. Even though, the sub-Tenon's anesthesia technique reduced the risk of complications of peribulbar/ retrobulbar anesthesia but the technique is still associated with a possibility of damage to optic nerve, retrobulbar hemorrhage, and ocular muscle injury. Topical anesthesia is used to block the afferent EDITORIAL

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Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery

Cited by 32 publications

References 45 publications

To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

To Study the Safety of Multi-dose Topical Anaesthetic Eye Drops One Month after Opening

Intraoperative head drift and eye movement: two under addressed challenges during cataract surgery

Local Anaesthesia in Cataract Surgery

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