Combined deep topical and superior subconjunctival anesthesia for extracapsular cataract extraction in a rural eye camp.

Abstract

Anesthesia for cataract surgery at eye camps needs to be simple, safe, and effective. We prospectively studied 98 patients undergoing cataract extraction in a rural eye camp in Thailand. Patients undergoing extracapsular cataract extraction with intraocular lens implantation (ECCE/IOL) received deep topical anesthesia with subconjunctival anesthesia. Patients undergoing phacoemulsification with intraocular lens implantation (Phaco/IOL) received topical anesthesia. Pain visual analog score, operative and anesthetic complications, operative time, and additional medications were recorded. A mean age of 68.7 vs 67.5 yr, an operative time of 16.1 +/- 6.7 min vs 12.0 +/- 4.7 min, and a median (interquartile range) pain score of 30.5 mm (12.3-54.6 mm) vs 20.0 mm (9.0-45.9 mm) were seen in the ECCE/IOL and Phaco/IOL groups, respectively. Three cases of ruptured posterior capsule occurred in the Phaco/IOL group. No additional anesthesia was needed. No anesthetic complications occurred. In a rural eye camp, deep topical anesthesia with subconjunctival anesthesia for ECCE/IOL and topical anesthesia for Phaco/IOL provide effective anesthesia for cataract surgery.