Comparison of Effects of Topical, Pinpoint and Retrobulbar Anesthesin in Cataract Surgery using Clear Corneal Incision

ABSTRACT

In order to evaluate the efficacy of topical anesthesia as an alternative to pinpoint or retrobulbar anesthesia in clear corneal cataract surgery, ninety patients were randomly assigned to the topical(n=30), pinpoint(n=30), or retrobulbar(n=30) anesthesia groups prospectively. All procedures including CCC, phacoemulsification, and foldable IOL implantation were performed using a temporal clear corneal approach by one surgeon(Joo). visual rehabilitation, change of astigmatism, degree of pain, comfortability, cooperation, and intraoperative and postoperative complications were compared. Intraocular pressure was higher in pinpoint anesthesia than in topical anesthesia at the beginning point of operation(p<0.05). Four hours after surgery, topical of pinpoint anesthesia group had significantly better visual acuity than retrobulbar anesthesia group(p<0.05). Pain score in topical anesthesia was marginally higher than that in retrobulbar anesthesia during the phacoemulsification. Comfortability was prominent in topical anesthesia group. There was no difference among the groups in change of astigmatism, cooperation and risk of serious complicatins. With these results it was found that topical anesthesia would be a safe, effective alternative to pinpoint or retrobulbar anesthesia in cataract surgery using clear corneal incision.