Clinical outcomes, surgeon and patient satisfaction following peribulbar versus topical anesthesia for phacoemulsification surgery and intraocular lens implantation- A comparative study

Introduction: Phacoemulsification technique for cataract using either peribulbar anesthesia (PA) or topical anesthesia (TA) has evolved in last decade. Only few studies has compared between two anesthetic procedures for phacoemulsification. We compared patient and surgeon satisfaction, clinical outcome between two anesthetic procedures. Materials and Methods: The Study was conducted during February 2017 to July 2017. Patients after being randomly assigned to group PA and TA were underwent phacoemulsification. Corneal condition, postoperative complication at day 1, best corrected visual acuity at day 40 were compared. Both patients and surgeons were asked questions on degree of analgesia and level of comfort respectively. Data was analyzed using appropriate test of significance. Results: 50 patients were taken into study in each group. No significant difference was noted between two groups pre-operatively. Patients in PA group felt statistically significantly less pain compared to TA group (χ2 = 11.78, df = 2, P = 0.0027). Satisfaction of surgeons was more with PA than compared with TA. [Relative Risk=1.49, (95% CI: 1.02-2.17)]. On day 1 postoperative complications were greater in TA group (76%) than compared to PA group (64%).Complications associated with anesthetic procedure were more in PA group than compared with TA group. Conclusions: Patient's satisfaction was statistically significantly greater in PA group compared to TA group. Surgeon's satisfaction was also not different from patient's satisfaction and found to be more with peribulbar block than compared to topical anesthesia. Clinical outcome remains unaffected by either of anesthetic technique.