The Cataract National Dataset Electronic Multi-centre Audit of 55,567 operations: anaesthetic techniques and complications

Eye (Lond). 2009 Jan;23(1):50-5. doi: 10.1038/sj.eye.6703031. Epub 2008 Mar 14.


Purpose: The primary aim of this study was to detail anaesthetic techniques and complications for cataract surgery in the UK.

Methods: The Cataract National Dataset was extracted from 12 National Health Service Trusts that used the same electronic patient record system between November 2001 and July 2006 on a total of 55,567 cataract operations.

Results: Anaesthesia was administered by an ophthalmologist in 56.7% of the cases, a career anaesthetist in 42.1% of the cases, a clinical assistant anaesthetist in 0.3% of the cases, and staff were not recorded in 0.9% of the cases. Local anaesthesia (LA) was used in 95.5%, with topical anaesthesia alone in 22.3% (range by site, 0-99.8%), topical and intracameral in 4.7% (range, 0-24.1%), subtenons in 46.9% (range, 0-81.8%), peribulbar in 19.5% (range, 0-63.4%), and retrobulbar in 0.5% (range, 0-5.3%). One or more minor complications occurred in 4.3% of 38,058 local blocks administered by either sharp needle or subtenons (blunt) cannula. Minor complications were 2.3 times more common with subtenons blocks (P<0.001). Serious complications, defined as sight or life threatening occurred in 25 eyes, 0.066%, undergoing sharp needle or subtenons cannula blocks. Sharp needle techniques had a 2.5-fold increased risk of serious complications compared with subtenons cannula techniques (P=0.026).

Conclusion: Subtenons anaesthesia was the most widely used anaesthetic technique for cataract surgery but wide variation existed by site. There was a low rate of reported LA complications. There was a statistically significant increased risk of serious complications with sharp needle anaesthesia compared with subtenons technique.

Publication types

  • Multicenter Study

MeSH terms

  • Ambulatory Surgical Procedures / standards
  • Anesthesia, Local / adverse effects
  • Anesthesia, Local / methods*
  • Anesthesia, Local / statistics & numerical data
  • Anesthesiology / standards
  • Anesthesiology / statistics & numerical data
  • Cataract Extraction / adverse effects
  • Cataract Extraction / methods*
  • Cataract Extraction / statistics & numerical data
  • Humans
  • Medical Audit
  • Ophthalmology / standards
  • Ophthalmology / statistics & numerical data
  • Reference Standards
  • United Kingdom