Abstract
Purpose: :
To compare the analgesic efficiency and patient discomfort/pain during a standard cataract surgery procedure under pure topical anaesthesia with either a combination of Tetracaine/Oxybuprocaine or Oxybuprocaine alone.
Methods: :
It’s a prospective study including 50 patients (100 eyes). Each of them had standard cataract surgery with phacoemulsification of both eyes by the same surgeon from August to October 2005. One eye (group A) got pure topical anaesthesia with a combination of Tetracaine and Oxybuprocaine (instillation of a drop of Oxybuprocaine 0.4% followed by 3 drops of Tetracaine 1% five minutes before surgery). The second eye (group B) received pure topical anaesthesia with Oxybuprocaine alone (3 drops of Oxybuprocaine O.4% five minutes before surgery). During operation no other anaesthetics than topical drops were given. Parameters evaluated were: patients age, gender, difficulty (cataract density 1–4), duration of the intervention, wound closure with or without stitch, power/type of implant, corneal toxicity (postoperative superficial keratitis punctata {sKP} level 1–3 ) and possible complications. We also compared the possible discomfort and/or pain during surgery using an analogical pain ladder levelled from 0 to 1O.
Results: :
The mean for age was 72,92 years. There were 22 male and 28 female patients. In both groups there was no statistically significant difference for average operation time (A: 10,84 min, B: 11,02 min), difficulty of intervention (mean cataract density; A: 1,16 B: 1,18) or postoperative sKP (A: 1,10; B: 1,05). All eyes had a soft IOL implanted with the help of a manual injector trough a 2.8mm surgical aperture. The average power of the implant was 20,49 D in group A and 21,20 D in group B. The percentage of final stitches was 28 % in group A and 32 % in group B. In all 100 eyes we were so fortuned not to have any complications. Evaluation of pain and/or discomfort immediately after the surgical procedure using the analogical pain ladder, showed an average pain lever of 1,62 in group A and 1,55 in group B.
Conclusions: :
Both methods of topical anaesthesia seemed to be of equal value showing no statistically significant difference between the combination of Tetracaine/Oxybuprocaine or Oxybuprocaine alone when evaluating for patient discomfort/pain. As all the other evaluated parameters showed no difference, single Oxybuprocaine drop regime is a good option when aiming to simplify anaesthetic procedure for cataract surgery.
Keywords: cataract • clinical (human) or epidemiologic studies: systems/equipment/techniques