ABSTRACT
Purpose: To compare the efficacy and safety of Proparacaine 0.35%- Fentanyl 0.0015% solution and Lidocaine 2.8% - Fentanyl 0.0015% solution as topical anesthesia for pharmacoemulfification with intraocular lens implantation. Methods: A prospective randomized, triple- masked clinical study. Ninety six patients with senile cataract were divided into two treatment groups Proparacaine - fentanyl group (PF group) and the Lidocaine Fentanyl group (LF group). Volume of anesthetic required latency and duration of anesthesia were compared. Visual analog pain scale was used to assess intraoperative patient's pain. Preoperative patient anxiety; surgeons and anesthesiologists assessment of the operative condition were also determined. Slit-lamp biomicroscopy was done on the first day postoperatively. Unpaired students T- test and descriptive statistics were employed with level of significance at p<0.05. Results: Similar volume of the anesthetics was used in both groups. Mean latency period for the PF solution was 0.51 minutes +/-0.18 (SD) which was significantly shorter than the LF solution at 3.14 minutes +/- 1.09 (p<0.05). Mean duration of anesthetic effect of the PF group was significantly shorter at 33. 47 minutes +/-4.57 while the LF group lasted 69.09 minutes +/- 16.20 9p<0.05). Majority of the patients in both groups [44 (905) PF group; 40 (85%) LF group] denied any pain or discomfort during surgery. Mean pain score was 0.16 PF group and 0.23 for the LF group. The surgeon noted optimal operative conditions while the anesthesiologist reported significant difference in patients response during surgery with hand squeezing noted in 7 (15%) patients in the LF group 9p<0.05%). There was no significant difference in biomicroscopic findings on day 1 postoperatively. Conclusion: Proparacaine 0.035% - fentanyl 0.0015% solution is as effective and as safe as lidocaine 2.8% - fentanyl 0.0015% solution for topical anesthesia in phacoemulsification with intraocular lens implantation.