With the ever increasing awareness among the urban population, regarding various methods that are available for cataract surgery, it made us inevitable to come out with an acceptable method of anaesthesia in the urban population.

Aim of this study is to find out whether the topical anaesthesia is a safe and a reliable method for performing the small incision cataract surgery (SICS).

Materials and Methods Consisted of 100 cataract patients, who visited the out-patient department of Vidya Eye Hospital, Vijayanagar, Bangalore, Karnataka State, India. Small incision cataract surgery was performed under topical anaesthesia for all these patients. The acceptance of Topical anaesthesia both by the patient and the surgeon were assessed by using relevant criteria in each case.

Results revealed that 93 percent of the patients accepted this method of anaesthesia, while in 94 cases surgeon felt very comfortable by this method of topical anaesthesia.

Conclusion our study concluded that the method of Topical anaesthesia in performing SICS is acceptable both for the patient and the operating surgeon.

1. Projections of the first epidemiological study of incidence of cataract blindness in India. Br J Ophthalmol 1990;74:341-3. Hennig A, Kumar J, Singh AK, Ansari A, Singh S, Gurung R, Foster A. World Sight Day and cataract blindness. Br J Ophthalmol 2002;86:830-1.
2. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: What is moderate pain in millimetres? Pain 1997;72:95-7.
3. Lee J, Stiell I, Hobden E, Wells G. Clinically meaningful values of the visual analog scale of pain severity. Acad Emerg Med 2000;7:550.
4. Smith R. Cataract extraction without retrobulbar anesthetic injection. Br J Ophthalmol 1990;74:205-7.
5. Eke, Tom, Thompson, John R. Serious complications of local anaesthesia for cataract surgery: A 1 year national survey in the United Kingdom. Br J Ophthalmol 2007;91:470-5.
6. Nielsen PJ. Immediate visual capability after cataract surgery: Topical versus retrobulbar anesthesia. J Cataract Refract Surg 1995;21:302-4.
7. Eke, Tom, Thompson, John R. Serious complications of local anaesthesia for cataract surgery: A 1 year national survey in the United Kingdom. Br J Ophthalmol 2007;91:470-5.
8. Nielsen PJ. Immediate visual capability after cataract surgery: Topical versus retrobulbar anesthesia. J Cataract Refract Surg 1995;21:302-4.      
9. Nielsen PJ. A prospective evaluation of anxiety and pain with topical anesthesia or retrobulbar anesthesia for small incision cataract surgery. Eur J Implant Ref Surg 1995;7:6-10.       
10. Maclean H, Burton T, Murray A. Patient comfort during cataract surgery with modified topical and peribulbar anesthesia. J Cataract Refract Surg 1997;23:277-83.
11. Zehetmayer M, Radax U, Skorpik C, Menapace R, Schemper M, Weghaupt H, et al . Topical versus peribulbar anesthesia in clear corneal cataract surgery. J Cataract Refract Surg 1996;22:480-4.
12. Johnston RL, Whitefield LA, Giralt J, Harrun S, Akerele T, Bryan SJ, et al . Topical versus peribulbar anesthesia, without sedation, for clear corneal phacoemulsification. J Cataract Refract Surg 1998;24:407-10.            
13. Fichman RA. Use of topical anesthesia alone in cataract surgery. J Cataract Refract Surg 1996;22:612-4.            
14. Gozum N, Altan-Yaycioglu R, Gucukoglu A, Arslan O. Does topical anesthesia increase patient's serum cortisol level? Int J Ophthalmol Visual Sci 2003;2:2.
15. Barequet IS, Soriano ES, Green WR, O'Brien TP. Provision of anaesthesia with single application of lidocaine 2% gel. J Cataract Refract Surg 1999;25:626-31.
16. Assia EI, Pras E, Yehezkel M, Rotenstreich Y, Jager-Roshu S. Topical anesthesia using lidocaine gel for cataract surgery. J Cataract Refract Surg 1999; 25:635-9.
17. Bardocci A, Lofoco G, Perdicaro S, Ciucci F, Manna L. Lidocaine 2% gel versus lidocaine 4% unpreserved drops for topical anesthesia in cataract surgery: A randomized controlled trial. Ophthalmology 2003;110:144-9.       
18. Soliman MM, Macky TA, Samir MK. Comparative clinical trial of topical anesthetic agents in cataract surgery: Lidocaine 2% gel, bupivacaine 0.5% drops, and benoxinate 0.4% drops. J Cataract Refract Surg 2004;30:1716-20.
19. Jacobi PC, Dietlein TS, Jacobi FK. A comparative study of topical vs. Retrobulbar anaesthesia in complicated cataract surgery. Arch Ophthalmol 2000;118:1037-43.           
20. Oksuz H, Tamer C. Efficacy of lidocaine 2% gel in pterygium surgery. Acta Ophthalmol Scand 2005:83:206-9.
21. Kongsap P, Wiriyaluppa C. A comparison of patient pain during cataract surgery with topical anesthesia in prechop manual phacofragmentation versus phacoemulsification. J Med Assoc Thai 2006;89:959-66.
22. Minasian DC, Mehera V. 3.8 Million blinded by cataract each year: Hennig A, Kumar J, Singh AK, Ansari A, Singh S, Gurung R, Foster A. World Sight Day and cataract blindness. Br J Ophthalmol 2002;86:830-1.
23. Collins SL, Moore RA, McQuay HJ. The visual analogue pain intensity scale: What is moderate pain in millimetres? Pain 1997;72:95-7.
24. Lee J, Stiell I, Hobden E, Wells G. Clinically meaningful values of the visual analog scale of pain severity. Acad Emerg Med 2000;7:550.
25. Smith R. Cataract extraction without retrobulbar anesthetic injection. Br J Ophthalmol 1990;74:205-7.
26. Eke, Tom, Thompson, John R. Serious complications of local anaesthesia for cataract surgery: A 1 year national survey in the United Kingdom. Br J Ophthalmol 2007;91:470-5.
27. Nielsen PJ. Immediate visual capability after cataract surgery: Topical versus retrobulbar anesthesia. J Cataract Refract Surg 1995;21:302-4.
28. Nielsen PJ. A prospective evaluation of anxiety and pain with topical anesthesia or retrobulbar anesthesia for small incision cataract surgery. Eur J Implant Ref Surg 1995;7:6-10.
29. Maclean H, Burton T, Murray A. Patient comfort during cataract surgery with modified topical and peribulbar anesthesia. J Cataract Refract Surg 1997;23:277-83.
30. Zehetmayer M, Radax U, Skorpik C, Menapace R, Schemper M, Weghaupt H, et al . Topical versus peribulbar anesthesia in clear corneal cataract surgery. J Cataract Refract Surg 1996;22:480-4.
31. Johnston RL, Whitefield LA, Giralt J, Harrun S, Akerele T, Bryan SJ, et al . Topical versus peribulbar anesthesia, without sedation, for clear corneal phacoemulsification. J Cataract Refract Surg 1998;24:407-10.

Dr K.M Suresh, MBBS, MS (OPH)

Medical Director Vidya Eye Hospital, Vijayanagar, Bangalore 560040, India