Comparison of Topical Versus Sub-Tenon's Anesthesia in Phacoemulsification at a Tertiary Care Eye Hospital

PURPOSE: To compare the effectiveness of topical and sub-Tenon's anesthesia in providing pain relief during phacoemulsification. METHODS: This randomized controlled trial was carried out at a tertiary eye care hospital, Coimbatore, Tamil Nadu, India. Patients who underwent phacoemulsification through self-sealing clear corneal incision with foldable intra-ocular lens implantation were randomized into two groups. Group 1 (n = 100) received topical anesthesia with 0.5% proparacaine (Paracaine, Sunways India Pvt. Ltd., India) drops. Group 2 (n = 100) received sub-Tenon's infiltration with 2% lignocaine (Xylocaine, AstraZeneca Pharma India Pvt. Ltd., India). As per study criteria, patients graded the pain during administration of anesthesia, during surgery and after surgery on a visual analogue pain scale. The surgeon graded overall patient co-operation. The complications were also noted. Data analysis was performed using Statistical Package for Social Sciences version 11. Student's t-test and Chi-square test were used for comparison of variables between the groups. RESULTS: Sub-Tenon's anesthesia provided statistically significant better intra-operative pain relief and patient satisfaction than topical anesthesiat. No statistically significant difference was noted between the two groups regarding pain during administration, postoperative pain, and surgeon satisfaction. CONCLUSION: Sub-Tenon's anesthesia provides better pain relief than topical anesthesia during phacoemulsification.