ORIGINAL PAPER
Comparison of surgeon comfort assessment
during phacoemulsification using bilateral topical anesthesia
versus ipsilateral topical anesthesia: a randomized
controlled study
Rashim Mannan
.
Archna Pruthi
.
Sumeet Khanduja
Received: 7 December 2016 / Accepted: 5 June 2017 / Published online: 14 June 2017
Ó Springer Science+Business Media B.V. 2017
Abstract
Aim To evaluate the effectiveness of bilateral use of
topical anesthetic eye drops during phacoemulsifica-
tion procedure as compared to use in one eye only.
Methods This is a prospective double-blind random-
ized case study of 180 cases undergoing phacoemul-
sification under topical anesthesia using 0.5%
proparacaine: Group 1 consisting of patients who
had topical anesthetic eye drop instilled into the
operating eye only and Group 2 consisting of patients
who had both their eyes anesthetized using topical
anesthetic eye drops. Phacoemulsification was done
using standard surgical technique. Main parameters
evaluated included number of intra-operative patient
counseling score (IPCS), surgical comfort score
(SCS), total phacoemulsification procedure time
(TPPT) and total operation time (TOPT).
Results A comparison of mean value of various
variables between Group 1 (60;33.3% cases) and Group
2 (120; 66.7% cases) using ‘‘t’’ test revealed that there
was a statistically significant difference for mean SCS
(78.38 ± 10.31 vs. 85.05 ± 8.70; p = 0.00), mean
IPCS (12.60 ± 3.11 vs. 6.63 ± 1.74; p = 0.00) and
mean TOPT (418.88 ± 89.59 vs. 341.64 ± 79.51;
p = 0.00), respectively. However, no statistically sig-
nificant difference existed for mean TPPT (143.57 ±
87.96 vs. 152.96 ± 78.99; p = 0.48).
Conclusion Simultaneous instillation of topical
anesthetic eye drops in both the eyes, i.e., operating
eye and the fellow eye as against practice of instilling
topical anesthetic eye drop in the operating eye only,
helps in decreasing the total surgical time by primarily
shortening the durations of pre- and post-ultrasonic
periods of surgery where effective globe stabilization
is wanted. This is achieved by better patient compli-
ance, which in turn enhances surgeon’s comfort during
phacoemulsification surgery.
Keywords Phacoemulsification Á Topical
anesthesia Á Surgical comfort Á Cataract surgery
Introduction
Because of marked improvements in surgical tech-
niques, it is no longer essential to achieve complete
akinesia of the eye during phacoemulsification with
intraocular lens implantation. As a consequence,
topical anesthesia has evolved into a relatively popular
technique. The topical technique includes eye drop
application of 4% lignocaine or 0.5% proparacaine
[1–5], eye drops plus intra-cameral injection of 1%
R. Mannan Á A. Pruthi
VisiCare Eye Centre, Tarn Taran, Punjab, India
S. Khanduja (&)
Department of Ophthalmology, Kalpana Chawla
Government Medical College and Hospital, Karnal,
Haryana, India
e-mail: drkhanduja@gmail.com
123
Int Ophthalmol (2018) 38:1235–1242
https://doi.org/10.1007/s10792-017-0587-2
@Phil_Robichaud
@deepthiw
@JoseServera