From the Guidelines
The usual anesthesia for cataract surgery is topical or local anesthesia, along with sedation, as determined by the patient's needs and the preferences of the patient and surgeon. According to the most recent study 1, the type of anesthesia management should be individualized, considering the type of implant and the patient's comfort level. The study, published in 2023 in the journal Ophthalmology, discusses the importance of patient-surgeon communication to determine the best anesthesia approach. Some key points to consider when choosing anesthesia for cataract surgery include:
- Topical anesthesia is often used, which can be administered as eye drops containing medications such as proparacaine, tetracaine, or lidocaine
- Local anesthesia, such as peribulbar or retrobulbar blocks, may be used in some cases, especially for anxious patients or those who cannot remain still
- Sedation, typically using medications like midazolam or fentanyl, may be added to help relax the patient while remaining conscious
- Intravenous access is generally recommended to treat potential adverse events when sedation/analgesic agents are administered, as noted in the study 1. The goal of anesthesia in cataract surgery is to minimize pain, discomfort, and complications while allowing for rapid recovery and minimal downtime. By considering the patient's needs and preferences, surgeons can determine the most appropriate anesthesia approach, as suggested by the study 1.
From the FDA Drug Label
Proparacaine hydrochloride ophthalmic solution is indicated for topical anesthesia in ophthalmic practice. Representative ophthalmic procedures in which the preparation provides good local anesthesia include measurement of intraocular pressure (tonometry), removal of foreign bodies and sutures from the cornea, conjunctival scraping in diagnosis and gonioscopic examination; it is also indicated for use as a topical anesthetic prior to surgical operations such as cataract extraction. Deep anesthesia as in cataract extraction: Instill 1 drop every 5 to 10 minutes for 5 to 7 doses.
The usual anesthesia for cataract surgery is topical anesthesia using proparacaine. The recommended dosage for deep anesthesia in cataract extraction is 1 drop every 5 to 10 minutes for 5 to 7 doses 2 2. Key points include:
- Proparacaine is used for topical anesthesia
- Dosage: 1 drop every 5 to 10 minutes for 5 to 7 doses for cataract extraction
- Indication: cataract extraction
From the Research
Anesthesia for Cataract Surgery
- The usual anesthesia for cataract surgery includes various regional, local, or topical anesthetic techniques and agents, as well as general anesthesia 3.
- Regional anesthesia is the most commonly used technique, with the peribulbar block being the most frequently employed method 3.
- Topical anesthesia is also a popular choice, with some studies suggesting it is a safe and effective alternative to injection anesthesia 4, 5.
- Local anesthetic agents such as lignocaine are commonly used, and an anesthesia-trained person often monitors the patient during surgery 3.
- The choice of anesthesia technique may vary depending on the country and the individual surgeon's preference 3.
- Some studies have compared the efficacy and safety of different anesthesia techniques, including topical anesthesia, subconjunctival infiltration, and intracameral anesthesia 6, 5.
- The use of oral sedation and topical anesthesia without anesthetic monitoring has also been shown to be a safe and cost-effective strategy for low-risk patients undergoing cataract surgery 4.