What type of anesthesia is used for cataract surgery?

From the Guidelines

Cataract surgery should typically use local anesthesia rather than general anesthesia, as it allows for quicker recovery, fewer complications, and eliminates risks associated with general anesthesia. The most common approach involves topical anesthesia with eye drops containing medications like proparacaine, tetracaine, or lidocaine that numb the surface of the eye. This may be supplemented with intracameral anesthesia, where lidocaine is injected directly into the anterior chamber of the eye during the procedure. Some patients also receive a peribulbar or retrobulbar block, which involves injecting anesthetic around the eye to block nerve signals more completely. During the procedure, patients usually receive intravenous sedation like midazolam or fentanyl to help them relax while remaining conscious.

• The specific anesthetic approach may vary based on patient factors, surgeon preference, and the complexity of the cataract case, but most patients can expect to be awake yet comfortable during this relatively brief outpatient procedure 1.
• Local anesthesia is preferred because it reduces the risk of complications and allows for faster recovery, which is essential for improving patient outcomes and quality of life 1.
• The use of local anesthesia in cataract surgery is supported by recent studies, which have shown that it is a safe and effective approach for most patients 1.
• In some cases, general anesthesia may be used, especially for anxious or claustrophobic patients, but this is less common and typically reserved for specific situations 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 type of anesthesia for cataract surgery is topical anesthesia using proparacaine hydrochloride ophthalmic solution 2 2.

• The recommended dosage for deep anesthesia in cataract extraction is 1 drop every 5 to 10 minutes for 5 to 7 doses.
• Proparacaine is used as a topical anesthetic prior to surgical operations such as cataract extraction.

From the Research

Types of Anesthesia for Cataract Surgery

• Topical anesthesia is a common method used for cataract surgery, which can provide good analgesia in most cases 3
• However, some patients may feel uncomfortable or experience pain during surgery, and superficial anesthesia can be intensified with subconjunctival infiltration or by modifying the application forms 3
• Intracameral anesthesia, primarily with unpreserved lidocaine 1%, can improve the efficacy of topical anesthesia and provide a routine method for cataract surgery 3, 4
• The combined use of topical anesthesia and intracameral lidocaine administration can increase patient cooperation and decrease the degree to which patients are bothered by tissue manipulation 4

Comparison of Anesthesia Methods

• A study comparing patient comfort during cataract surgery with topical anesthesia versus topical anesthesia and intracameral lidocaine found no significant difference in patient-reported pain scores 4
• However, patients in the lidocaine group reported being less bothered by tissue manipulation and showed more patient cooperation 4
• Both topical anesthesia alone and topical anesthesia plus intracameral lidocaine can provide good operative conditions for the surgeon and comfortable surgical circumstances for the patient 4

Local Anesthesia Techniques

• Various local anesthesia techniques are available for cataract surgery, including topical anesthesia, subconjunctival infiltration, and intracameral anesthesia 5
• A comparative evaluation of clinical techniques in terms of efficacy, akinesia, and patient-perceived pain during both anesthesia administration and intraoperative cataract surgery is necessary to establish the overall benefits and efficacy of the various local anesthesia procedures 5