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L.–H. Chuang, C.–C. Lai, H.–H. Song, K.–J. Yang, W.–C. Ku; No Eye Padding After Phacoemulsification Under Topical Anesthesia . Invest. Ophthalmol. Vis. Sci. 2005;46(13):746.
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Purpose: To assess the essentials of eye padding after uneventful phacoemulsification under topical anesthesia. Methods: A prospective randomized study comprised 284 consecutive patients was performed. Surgery included a temporal, single–plane, 3.0 mm wide clear corneal incision and a side–port paracentesis under topical anesthesia with nonpreservative lidocaine 2% drops. The cataract extraction was performed by the bimanual stop–and–chop endocapsular phacoemulsification technique. The clear corneal incision was enlarged to a maximum of 4.0 mm and a foldable hydrogel IOL was implanted. The corneal wound was sutured with one stitch of 10–0 nylon to ensure no leakage. Instead of conventional eye padding after the operation, patients wearing plastic transparent shield were required to be investigated for pain, foreign body sensation, and tearing by the questionnaire. Corneal fluorescent staining was documented as well at first day postoperatively. Results: In a total of 284 consecutive patients were enrolled. Mean age was 64.07 years old. One hundred and sixteen in 284 patients (41%) were diabetic mellitus. Seven patients were padded and excluded after surgery because of 3 vitreous loss, 2 with chemosis and 2 with conjuntival oozing. All patients felt mild or no pain without padding at the first day after surgery. Only 8/284 (3%) patients experienced mild to moderate FBS. Only 40/284 (14%) had mild corneal staining, 54/64 had not any staining. However, 82/284 (29%) experienced mild to moderate tearing. Four in 284 cases were measured elevated IOP. Mean follow–up time was 10±6.7 months, and no acute endophthalmitis occurred till now. The BCVA of LogMAR: Preoperative: 0.22 ∼ 4, (average 1.23, SD 0.93) Postoperative: 0 ∼ 3, (average 0.43, SD 0.48), improved significantly, p–value<0.05 (paired t test). Conclusions: It is feasible to let patient go home without eye padding in uncomplicated phacoemulsification with IOL implantation under topical anesthesia.
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