Pain and anxiety assessment in topical vs. peribulbar anesthesia in cataract surgery

The aim of this study was to compare topical with peribulbar anesthetic technique as regards pain and anxiety in patients undergoing phacoemulsification cataract surgery. Hundred patients undergoing phacoemulsification procedure were enrolled in the study. Patients were divided into two groups, topical and peribulbar anesthesia was used for group I and II respectively. Pain assessment was done using visual analogue pain scale following administration of the local and topical anaesthesia, immediately after surgery, 2 hours postoperatively and overall pain experience. The Hamilton Anxiety Rating Scale [HARS] was used to assess the overall level of anxiety in the two studied groups. Pain score was significantly higher for Peribulbar group immediately after the block and over all pain experience [P value <0.01]. The two groups did not show any significant difference in the level of pain during the surgery and in the early post operative period. The topical group reported less perioperative anxiety compared to the Peribulbar group, but this difference did not reach significant level [P value= 0.6]. Patients undergoing phacoemulsification procedure under topical anesthesia experience less pain than patients received peribulbar blockade. Both techniques produce mild level of anxiety with less extent in topical group

Corneal perforation in a patient with behcet's disease

To report a rare case of Behcet's disease with corenal perforation as an ocular manifestation. a young patient was presented with corenal perforation as an ocular manifestation for behcet's disease. Young patient with a known case of systemic behcet's disease presented with corenal perforation treated by cyanocarylate glue as primary stage then lamellar keratoplasty to improve his visual acuity. behcet's disease can present rarely with corenal perforation as ocular manifistation with perilimbal vascularization. this unusual case reiterates that behcet's disease is essentially a clinical diagnosis. an awareness of the varied presentation, together with a detail history and physical examination, as well as consultations among various specialties is essential in order not to miss the diagnosis