ABSTRACT
To compare the effect of preservative free lidocaine 1% anterior chamber irrigation [intracameral] with topical anesthesia, continuous retro-bulbar anesthesia and standard retro-bulbar anesthesia in cataract surgery. 81 patients were subject to cataract extraction, with or without glaucoma surgery. Patients underwent full systemic and ocular examination prior to surgery. Blood analysis, liver and kidney function were also done. The first group included 25 eyes and were operated with preservative free lidocajne 1% anterior chamber irrigation [intracameral] after Benoxinate topical anesthesia. The second group included 22 eyes and were operated with continuous retro-bulbar anesthesia using retro-bulbar cannula. The third group included 34 eyes and were operated with standard retro-bulbar anesthesia. Patients in the first group experienced minimal discomfort and good tolerance to microscope light. Patients in the second group experienced some distress by the continuous touch of the retro-bulbar cannula, which was mal-directed in a few cases. Patients in the third group experienced some anxiety and pain with prolongation of surgical time. Preservative free lidocaine 1% anterior chamber irrigation after topical anesthesia seems to be an excellent method comparable to the standard retro-bulbar anesthesia in anterior segment ocular surgery. Continuous retro-bulbar anesthesia offers pain free post-operative period especially required for qat withdrawal effect