Topical Anesthesia for Cataract Surgery: The Patients' Perspective

Apil, Aytekin; Kartal, Baki; Ekinci, Metin; Çağatay, Halil Hüseyin; Keleş, Sadullah; Ceylan, Erdinç; Çakıcı, Özgür

doi:10.1155/2014/827659

Cited by 12 publications

(12 citation statements)

References 14 publications

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“…Similarly, Apil et al 6 reported that intraoperative pain was not associated with age or gender in their study. However, in a study including 506 patients, Tan et al 18 found that female patients experienced more pain during cataract surgery, while Gombos et al 19 reported that young patients were more sensitive to pain during cataract surgery.…”

Section: Discussionmentioning

confidence: 71%

“…In a recent study investigating the analgesic efficacy of topical anesthesia for phacoemulsification surgery, pain was reported by 89.5% of the patients. 6 In another study including 124 eyes of 96 patients, pain was reported at a rate of 71.8% among patients undergoing cataract surgery under topical anesthesia. However, in this study, deep topical anesthesia was achieved using topical anesthetic drops as well as sponges soaked in an anesthetic substance applied to the inferior and superior fornices.…”

Section: Discussionmentioning

confidence: 97%

“…4 Although the use of topical anesthesia during phacoemulsification surgery is a faster method and eliminates the risk of complications associated with local anesthesia, it has been reported that patients experience intraoperative and/or postoperative pain at a rate of 34 to 90%. 5,6,7 In most studies the intraoperative and/or postoperative pain is reported as mild, but in some patients the pain is severe enough to require intervention and lasts for days. 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…5,6,7 In most studies the intraoperative and/or postoperative pain is reported as mild, but in some patients the pain is severe enough to require intervention and lasts for days. 5,6 …”

Section: Introductionmentioning

confidence: 99%

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Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain

Dadacı¹,

Borazan²,

Acır³

2016

tjo

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Objectives:Evaluation of pain during and after phacoemulsification with topical anesthesia in patients with senile cataract and investigation of factors related with pain.Materials and Methods:Ninety-two adult patients scheduled for routine clear corneal phacoemulsification with topical anesthesia who had no previous cataract surgery in their fellow eyes were included in the study. Verbal pain scale and visual analog scale were used to measure pain intensity. Demographic characteristics, concomitant systemic diseases, drug consumption, need of additional anesthesia during surgery, surgical complications, duration of surgery and surgeon comfort were also evaluated for each patient.Results:Seventy-two patients (78.3%) reported pain during surgery and 68 patients (73.9%) reported pain in the period after the surgery. When the intensity of pain during the surgery was evaluated, the percentage of patients reporting mild, moderate and intense pain was 35.9%, 25.0% and 17.4%, respectively. The average verbal pain score during the surgery was 1.4±1.0 (0-3). Reported pain level was not associated with age or gender (p>0.05). Diabetic patients and patients who consumed nonsteroidal anti-inflammatory drugs in the morning before operation reported less pain during and after the surgery (p<0.05). There were no complications except posterior capsule rupture in one patient. Duration of surgery was longer in patients who reported pain during surgery (p<0.05). There was no significant difference between pain reported during surgery and surgeon comfort (p>0.05).Conclusion:Patients frequently experience pain during phacoemulsification with topical anesthesia. Although pain perception does not affect surgical success, preoperative administration of analgesics in suitable patients or giving additional anesthesia to patients reporting severe pain during surgery may increase patient comfort.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

“…5,6,7 In most studies the intraoperative and/or postoperative pain is reported as mild, but in some patients the pain is severe enough to require intervention and lasts for days. 5,6 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain

Dadacı¹,

Borazan²,

Acır³

2016

tjo

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“…Pain score varied among types of cataracts and was highest in mature cataracts and least in posterior subcapsular cataracts [32] . Subtenon was superior to intravenous Fentanyl for perioperative anaesthesia in infants undergoing cataract surgery measured by cries pain score [33] .…”

Section: Comparison Of Pain Scorementioning

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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Pain Perception of the First Eye versus the Second Eye during Phacoemulsification under Local Anesthesia for Patients Going through Cataract Surgery: A Systematic Review and Meta-Analysis

Shi

Yuan

Zee

2019

Journal of Ophthalmology

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Background. Phacoemulsification under local anesthesia is regarded as the major surgery for cataract treatment. Recent research has compared the pain perception between the first eye and the second eye during phacoemulsification. However, these studies have also yielded controversial findings. Consequently, we performed a systematic review and a meta-analysis to investigate the difference in the pain perception between the first and second eyes during phacoemulsification. Method. We searched the PubMed, EMBASE, and Cochrane CENTRAL databases for the studies published up to October 5, 2018. Prospective observational studies were included. The meta-analysis was conducted by means of random-effects model and fixed-effects model according to the heterogeneity. Evaluation of the methodological quality of studies was based on Newcastle-Ottawa Scale (NOS). Results. Overall, eight studies were included in the meta-analysis. The analysis of pooled data showed that the pain scores of the first eye shortly after surgery under local anesthesia were significantly lower as compared to the second eye (WMD: 0.69; 95% CI: 0.40, 0.98; P<0.00001). The average pain scores of the first eye shortly after surgery under the topical anesthesia were also lower than those of the second eye (WMD: 1.08; 95% CI: 0.79, 1.36; P<0.00001). Conversely, anxiety scores in the first eye surgery were significantly higher than those in the second eye surgery (SMD: −0.40; 95% CI: −0.64, −0.16; P=0.001). However, the difference of the pain scores accessed on the first postoperative day between the first and second eye surgeries (WMD: −0.05; 95% CI −0.40, 0.31; P=0.79) as well as cooperation grades of patients between the first and second eye surgeries (WMD: 0.35; 95% CI −0.07, 0.76; P=0.10) was not statistically significant. Conclusion. Patients experienced more pain in the surgery of the second eye than that of the first eye, which probably related to lower anxiety before the second surgery. It suggests that we should consider preoperative intervention to reduce the perceived pain during second eye cataract surgery.

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Topical Anesthesia for Cataract Surgery: The Patients' Perspective

Cited by 12 publications

References 14 publications

Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain

Pain Perception in Phacoemulsification with Topical Anesthesia and Evaluation of Factors Related with Pain

Local Anaesthesia in Cataract Surgery

Pain Perception of the First Eye versus the Second Eye during Phacoemulsification under Local Anesthesia for Patients Going through Cataract Surgery: A Systematic Review and Meta-Analysis

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