Sekundo W.

Department of Ophthalmology, Phillips University, Marburg, Germany

Background: To compare the effect of xylocaine jelly and intracameral lidocaine with a well proven low risk subtenon´s technique in self-sealing sclerocorneal phakoemulsification.
Method: 20 eyes were enrolled into the pilot study, receiving either a combination of topical 2% xylocaine jelly and 1.5ml of intracameral 1% lidocaine or sub-Tenon´s infiltration with 2ml of 2% xylocaine. All patients underwent a standard divide and conquer phakoemulsification procedure through a superior or temporal sclerocorneal frown incision followed by ipmplantation of a PMMA-IOL. Exclusion criteria were: mature cataracts, deafness, under 30 years of age. Intraoperative pain was indicated by the patient by squeezing bedside nurse´s hand, who allocated it to particular stages of surgery on a special chart. After surgery, patients assessed the pain experienced using a 10 units visual analogue scale.
Results: Pain was indicated during 0.75 stages of operation in the sub- Tenon´s group as well as in the topical group, however the main overall subjective pain score was 2.75 in the jelly group, but only 1.25 in the Subtenon's. Two eyes had to be converted to sub-Tenon´s immediately upon first touch of the conjunctiva. This study is being continued up to a total of 100 eyes in order to improve the statistical analysis. The updated data will be reported at the meeting.
Conclusion: Subtenon´s anaesthesia appears to provide a better intraoperative comfort than xylocaine jelly/intracameral anaesthesia for sclerocorneal incision cataract surgery.

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