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J. Collins, R. Humphry; Intracameral Cefuroxime Is Less Painful Than the Subconjunctival Route During Cataract Surgery . Invest. Ophthalmol. Vis. Sci. 2005;46(13):3833.
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Purpose: We carried out this study to compare patients' perception of pain when receiving prophylactic antibiotics via one of two methods – either the subconjunctival or intracameral route during routine cataract surgery. The study took place within the Day Surgery Unit at Salisbury District Hospital between February and June 2003. Methods: This prospective study involved 79 eyes of 79 patients undergoing routine phacoemulsification cataract surgery and intraocular lens implantation under topical anaesthesia. Patients were randomly allocated to receive either intracameral or subconjunctival Cefuroxime at the end of surgery. Patients were requested to score their pain from 0–10 according to the visual analogue pain scale following administration of antibiotic by either intracameral or subconjunctival route and at 4 other stages throughout their surgery. The other stages were – administration of topical anaesthesia, hydrodissection, removal of adhesive drapes and an overall pain score. An explanation of the purpose of the study and the visual analogue pain scale was given to all patients included in the study preoperatively. Results: There was a statistically significant difference in the level of pain perceived by the patients in each group. The intracameral subjects recorded significantly lower pain scores, p< 0.00001 with 50% of the sample recording scores <2 and 100% of patients scoring <5. The subconjunctival subjects recorded pain scores across the entire scale 0–10, with scores peaking in the range 4–6. Conclusions: If prophylactic antibiotics are to be used during cataract surgery then this study demonstrates clearly that intracameral administration is significantly less painful than the subconjunctival route.
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