Waqarul Huda, Fehmi M S, Sharjeel Sultan, Uzma Fasih, Attiya Rehman, Arshad Shaikh.
Randomized clinical trial of topical versus retrobulbur anesthesia for phacoemulsification: comparison of patient satisfaction.
Pak J Ophthalmol Jan ;28(3):157-60.

Purpose: Current anesthetic options for phacoemulsification typically include injection techniques, such as retro bulbar block, peribulbar block, sub-Tenon injection and topical anesthesia. Consensus does not yet exist on whether regional or topical anesthesia is the superior option, although topical anesthesia is being more commonly used. 1 Material and Methods: This was a randomized clinical trail done at eye Operation theatre at Abbasi Shaheed Hospital Karachi. In group A topical anesthesia (TA), patients received a minimum total of 5 doses of 2% topical proparacaine. For performing retrobulbar (RBA) block in group B, patients received 2 % lidocaine anesthetic solution 1-2 ml into the retrobulbar space. Phacoemulsification was performed using clear corneal phacoemulsification and implantation of IOL. We used a scoring system, the lowa satisfaction with Anesthesia scale (ISAS) a self administered written questionnaire for assessment of patient satisfaction. Results: Mean lowa score in topical group was 2.71 while it was 2.3 in retrobulbar group. Median lowa score in topical group was 3 while it was 2.54 in retrobulbar group. The difference in mean lowa score was found to be statistically significant between two groups (p value < 0.05). Conclusions: Topical anesthesia (TA) is a safe, satisfactory alternative to retrobulbar (RBA) anesthesia without causing discomfort to the patients.

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