Topical versus peribulbar anesthesia in cataract surgery

Purpose: To compare the use of topical anesthesia with that of peribulbar anesthesia in cataract surgery. Setting: Quinze-Vingts Hospital, Paris, France. Methods: This prospective study comprised 45 patients who had phacoemulsification and intraocular lens implantation in both eyes with 1 to 9 months between surgeries. Each patient had peribulbar anesthesia for one surgery and topical anesthesia for the other. The anesthesia method for the first eye was randomly selected. After surgery, patients were asked to rate their pain and whether they preferred one anesthesia technique over the other. Results: When topical anesthesia was given, 82.2% of patients required no intravenous medications. Overall, 62.2% preferred topical over peribulbar anesthesia, with most patients citing the lack of periocular injection as the reason. Conclusion: Despite the increased technical difficulty, topical anesthesia proved an effective alternative to peribulbar anesthesia for cataract surgery that avoids the risks of periocular injection and reduces the need for intravenous medications.