Topical Anesthesia Versus Topical Anesthesia Plus Intracameral Xylocaine for Phacoemulsification Surgery

Aim of the Study: The aim of the study is to compare preservative-free xylocaine over topical anesthesia alone during phaco surgery regarding patients comfort and pain during the procedure.Methods: Our study was conducted on two groups: Group (1) using intracameral preservative-free Xylocaine combined with topical anesthesia, and group (2) receiving topical anesthesia only.Exclusion criteria included hearing impairment, dementia, movement disorders, excessive anxiety and poor fixation.In the group receiving intracameral anesthesia, a 5mm capsulorrhexis hydrodissection was performed by injecting 0.5ml of preservative-free Xylocaine 1%.Measurements:•Hemodynamics included heart rate (HR), mean arterial pressure (MAP), and arterial oxygen saturation (Spo2).•For eye movements, a score, 0=no movements, 1=nystagmoid movements and 3=Bell s movements.•Pain was measured by visual analog scale (VAS) score immediately at the end of the procedure.•Time of surgery was recorded, patient s and surgeon’s satisfaction were also measured.Results: There was no difference in surgeon’s and patient’s satisfaction in both groups. Eye movements during surgery were more frequent in group (2), yet there was no statistical significant difference in both groups. Although the majority of patients in both groups of our study experienced no or minimal discomfort and pain, the difference in mean pain score for the two groups was statistically significant.Conclusion: Combining topical and intracameral anesthesia for phaco surgery offers significant benefits over topical anesthesia alone in terms of patient s comfort.