Patient Reported Outcomes of Retrobulbar versus Topical Anaesthesia in Cataract Surgery - a Prospective Observational Trial.

Abstract

Objective: The aim of this prospective clinical, monocentric observational study was to assess the pain perception of patients during cataract surgery.

Methodology: Patients undergoing cataract surgery at the Department of Ophthalmology at the Medical University of Graz were recruited. Patients who received retrobulbar anaesthesia (RBA) were compared to those who received topical drop anaesthesia (TA) with (TAG) or without an anaesthetic gel. Exclusion criteria were complications during the cataract surgery requiring additional steps including anterior vitrectomy and the placement of a Malyugin ring. The patients were interviewed postoperatively regarding their perceived pain experience during cataract surgery, using the Numeric Rating Scale. Additionally, the mean intraoperative blood pressure was recorded for correlation with the subjective assessment of pain.

Results: Overall, 201 patients could be enrolled. Among them, 105 patients underwent cataract surgery under RBA, 50 patients under TA and 46 patients under TAG. The average pain score under RBA was 0.35 ± 0.87, under TA 1.32 ± 1.22, and under TAG 0.89 ± 0.97. Statistical analysis revealed a significant difference between RBA and the two topical anaesthesia methods (p < 0.01). However, no significant difference was found between the two topically applied methods, TA and TAG (p = 0.64). The mean intraoperative blood pressure could be obtained for a total of 32 patients. The average difference in values before and during the operation was + 1.88 mmHg under RBA and + 3.33 mmHg under TAG (p > 0.05).

Conclusion: Our results indicate that patients receiving RBA have significantly less pain intraoperatively than those with TA and TAG. The addition of an anaesthetic gel to TA showed a slight, but not significant, reduction in pain.