ABSTRACT
Our objective was to describe the safety and efficacy of a new analgesia protocol that enables the surgeon to maintain control over an alert patient experiencing seemingly painless ambulatory cataract surgery, while eliminating the risks and side effects associated with general, local, and intracameral anesthesia. This study was carried out on two thousands cataract surgery cases. This technique produces profound ocular analgesia, avoiding any undesired sedative effects, using very low-dose, titrated, intravenous alfentanil. Complete control of the uncooperative patient, including lid squeezing and ocular and genera! body movements, is obtained whenever necessary using very low-dose, titrated, intravenous propofol. Success was defined as surgery completed in a controlled manner without the need to convert to general, local, or intracameral anesthesia and the patent's experience being perceived as pain free. One thousand nine hundred ninety-five [99.75%] of the cases were successful without ever deviating from the protocol. This analgesia protocol offers advantages for cataract surgery. It virtually eliminates the morbidity of cataract surgery associated with other anesthesia techniques while providing excellent and reliable control with minimal side effects. It allows for an immediate postoperative recovery with instantaneous vision restoration. These patients are generally awake, alert, and retain their protective reflexes