Comparison of Peribulbar Anaesthesia with Topical Anaesthesia in Small Incision Cataract Surgery

Aim: To compare the efficacy of peribulbar with topical anaesthesia using Lignocaine 2% drops and jelly in manual small incision cataract surgery by quantitatively assessing both, the pain scores of the patient and the surgeon’s satisfaction. Materials and Methods: This was a randomized comparative study. The first 150 eyes of 148 patients were chosen. They were operated by two experienced surgeons. 5ml of 2% Lignocaine with adrenalin and 2ml of 0.5% Bupivacaine was given as peribulbar anaesthesia . 4% Lignocaine drops followed by Lignocaine 2% jelly was used as topical anaesthesia. Patients were assessed during various steps of the surgery and then 4 hours after surgery using the modified visual analogue pain scale. After each surgery surgeon’s experience was assessed based on patient’s cooperation, difficulty due to ocular movements and Anterior chamber stability. Data was analysed using appropriate statistical methods and using Chi-square test and p-values to compare the two groups. Results: There were78 eyes were in peribulbar group and 72 in the topical group. Grade 0-1 pain was in 96% in peribulbar group and 100% in topical anaesthesia group. The mean pain score 4 hours after surgery was significantly higher with the topical group as compared to the peribulbar group (p=0.00..). Surgeons evaluation of the efficacy of anaesthesia indicates that unwanted ocular movements significantly decreased the surgeon’s satisfaction (p=0.00073). Conclusion: Topical anaesthesia in the form of Lignocaine drops and jelly is an effective alternative to peribulbar anaesthesia for small incision cataract surgery.