A comparison of patient pain during cataract surgery with topical anesthesia in Prechop Manual Phacofragmentation versus phacoemulsification.

OBJECTIVE To compare the pain level and complications during cataract surgery with topical anesthesia in Prechop MPF versus phacoemulsification. STUDY DESIGN Prospective randomized comparative study. MATERIAL AND METHOD One hundred patients, undergoing small incision cataract surgery under topical anesthesia, were allocated randomly to perform Prechop MPF (n = 50) or phacoemulsification (n = 50). Patients were asked to rate their pain level on a 10-point visual analog pain scale during the administration of the anesthetic, during the surgery and after surgery. The surgeon recorded his subjective assessment of patient cooperation and surgical complications. RESULTS The mean pain score during surgery was 1.64 +/- 1.48 (SD) in the prechop MPF group and 0.92 +/- 1.34 (SD) in the phacoemulsification group. The difference between groups was statistically significant (p = .001). There was no significant difference in pain scores for delivery of anesthesia (p = .077), or after surgery (p = .221) and no significant difference in patient cooperation (p = .446) and surgical complications in either group. CONCLUSION Patients having cataract surgery under topical anesthesia in the prechop MPF group had more intraoperative pain than patients in the phacoemulsification group. However there was no significant difference in patient cooperation and surgical complications between the groups.