The use of a new viscoelastic substance combined with anaesthetic in cataract surgery by phacoemulsification

Abstract

AIM OF THE STUDY: To compare and estimate the safety and efficacy of a new viscoelastic substance combined with anaesthetic used in phacoemulsification surgery.

METHOD: Eight hundred seventyfour patients observed at the Department of Optlamology and the Department of Family Medicine of the General State Hospital of Nikea-Piraeus (Greece) submitted to a phacoemulsification surgery for cataract during a six-month period were randomly divided into two groups of 437 patients each. All patients were operated using the same scheme of anesthesia, consisting of ropivacaine drops 0.75% and lidocaine gel 2% immediately before surgery. Viscoelastic without anesthetic was used during the operation of the patients of group 1, while the new viscoelastic with anesthetic (sodium hyaluronate 1.5% and lidocaine 1%) (viscoanesthetic) was used in group 2. No intravenous sedation was given to either group. Patients were asked to complete a questionnaire including irritation or pain sensation during various phases of the operation, after the operation, as well as the degree of satisfaction from the anesthesia scheme. The participating surgeons were called to estimate post-operative corneal edema.

RESULTS: In the first group of patients (viscoelastic without anesthetic) 15.6% of them reported pain during intraocular lens insertion, 24.6% reported burning sensation during acetylcholine injection, 17.4% reported pain during placement of the corneal suture, 4.1% immediate postoperative pain and 1.8% night pain. In the second group of patients (viscoelastic with anesthetic) the percentages were 1.8%, 3.2%, 4.3%, 3.6% and 1.4% respectively. 78.9% of the first group and 82.1% of the second group had no corneal edema on the first postoperative day. 91.1% of the patients of the first group and 97.3% of the second group were satisfied.

CONCLUSION: The new combination of viscoelastic and anesthetic is a safe and efficient choice for the cataract surgeon who uses only anesthetic drops for cataract operations. It minimizes patients’ complaints and helps in achieving better cooperation during cataract surgery.