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Aims: To assess the quality of analgesia, level of comfort of patients and surgeons and incidenceof complications after topical anaesthesia with supplemental intracameral lignocaine as compared toperibulbar block in patients undergoing phacoemulsification.Materials and Methods: It was a prospective observational study done in 66 patients havinguncomplicated senile cataracts who underwent phacoemulsification with foldable IOL implantation ofboth eyes. One eye of each patient was operated under peribulbar blockand the other eye under topicalanaesthesia with supplemental intracameral lignocaine after 2 weeks. In Group T, topical anaesthesia wasachieved by instilling proparacaine hydrochloride 0.5% and preservative free 1% lignocaine was used forintracameral analgesia. Peribulbar block was administered with 5-7 ml of 2% lignocaine with 1:10000adrenaline. Patient comfort, feeling of pressure during block, quality of analgesia intraop and 4 hourspostop, and surgeon’s comfort were documented.Results: Group P patients had significantly higher pain score, discomfort and pressure on eye duringadministration of block compared to Group T. Both groups had comparable pain scores and patient’sdiscomfort. Pressure on eye intraop and postop and intraoperative positive pressure were also similar inboth groups. Group P had significantly higher incidence of subconjunctival hemorrhage (80% vs 10%) andchemosis of conjunctiva. (80% vs 0%).Conclusion: Topical anaesthesia with supplemental intracameral lignocaine can be considered as a superioranaesthetic technique for phacoemulsification than peribulbar block as it is associated with significantlyhigher patient comfort and lower complications with comparable surgeon’s comfort.Keywords: Topical anaesthesia, Intracameral, Peribulbar anaesthesia, Phacoemulsification.

indian journal of clinical and experimental opthalmology

A comparative study of effectiveness of topical with supplemental intracameral lignocaine versus peribulbar anaesthesia for phacoemulsification with foldable intraocular lens implantation