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Limbal anesthesia as effective as topical for phaco, study finds
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Limbal anesthesia was as well tolerated and as effective in providing analgesia as topical anesthesia for cataract surgery, according to a clinical study.
Carlo Cagini and colleagues at the University of Perugia in Italy randomly assigned 117 patients undergoing routine phacoemulsification to receive either limbal or topical anesthesia. In limbal anesthesia, preservative-free lidocaine HCl 4% was applied to the temporal perilimbal area for 45 seconds immediately before surgery. For topical anesthesia, lidocaine 4% was instilled at 10-minute intervals four times before surgery. The investigators measured phaco time, perioperative pain, visual outcomes and intraoperative complications. Patients rated pain on a scale of 1 to 10, with 10 being severe pain and 1 no pain.
Both types of anesthesia were tolerated well, with 92% of patients in the topical anesthesia group and 95% in the limbal group reporting pain scores of 1 to 3. The difference was not statistically significant, according to the study authors.
None of the patients required supplemental anesthesia and no intraoperative complications were recorded. None of the eyes had epithelial defects at the end of surgery or at any of the postop follow-up visits.
The study is published in the December issue of Acta Ophthalmologica Scandinavica.