Aim of the study: We performed a prospective study to compare two techniques of local anesthesia: topical and subtenon anesthesia. Twenty-five patients underwent cataract surgery on both eyes by phakoemulsification and insertion of foldable lenses in the capsular bag. The second eye was operated 24 hours after the first one. We evaluated patient confort, surgeon confort, surgical complications and pupillary diameter evolution during the procedure.
Results: 64% of patients preferred subtenon anesthesia procedure. Surgeon confort was better with subtenon anesthesia. No surgical complications occurred in either group. The pupillar diameter evolution was different, decreasing for about 25% for topical anesthesia and 15% for subtenon anesthesia.
Conclusion: Subtenon anesthesia is more comfortable for the patient: deeper anesthesia, reliable, longer lasting; light tolerance is better. It is also more comfortable for the surgeon: better pupillar dilatation during the procedure. Topical anesthesia has inconstant efficiency.