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Abstract #6577 Published in IGR 3-2
Cataract surgery under topical anesthesia in patients with coexisting glaucoma
Jacobi PC; Dietlein TS; Jacobi FKJournal of Cataract and Refractive Surgery 2001; 27: 1207-1213
PURPOSE: To evaluate and compare levels of patient discomfort and complications during phacoemulsification with implantation of a foldable intraocular lens (IOL) under topical lidocaine hydrochloride in patients with and without various forms of chronic open-angle and chronic angle-closure glaucoma. METHODS: This prospective nonrandomized comparative study comprised 176 eyes of 176 patients with various forms of chronic open-angle and chronic angle-closure glaucoma. Eyes with cataract and without a glaucoma diagnosis or history of intraocular surgery served as a control group (n = 212). All patients received a minimum of five doses (two drops per dose) of topical lidocaine hydrochloride 2% before standard temporal clear corneal phacoemulsification and foldable IOL implantation. No intracameral anesthetic injection was given, and no systemic sedatives were used. The main outcome measures were the number of complications and adverse events. RESULTS: The intraoperative complication rate in all patients (n = 388) was: capsule tear, 1.3%; zonule tear, 1.8%; vitreous loss, 1.0%; and iris prolapse, 0.8%. No statistically significant differences in intraoperative or early postoperative complications were found between the glaucoma and control groups. The mean pain scores of patients were 0.38 ± 1.1 (SD) in the glaucoma group and 0.36 ± 0.8 in the control group (p = 0.21). Patient preference for cataract surgery under topical anesthesia was similar in both groups. CONCLUSIONS: Surgery-related complications and patient discomfort were similar in patients with and without glaucoma who had phacoemulsification and IOL implantation under topical anesthesia. These results indicate that topical anesthesia is safe for routine phacoemulsification with foldable IOL implantation in patients with glaucoma, and does not compromise patient comfort.
Dr P.C. Jacobi, University Eye Hospital of Cologne, Joseph-Stelmannstrasse 9, D-50931 Cologne, Germany. Philipp.Jacobi@uni-koeln.de
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.17 Anesthesia (Part of: 12 Surgical treatment)
