Comparison of topical versus peribulbar anaesthesia for manual small incision cataract surgery with intraocular lens implantation

Background: Manual small incision cataract surgery (MSICS) is an alternative to phacoemulsification for high volume cataract surgery especially in developing countries. Aim of this study is to compare patient and surgeon satisfaction, anaesthesia related and post-operative complications following topical (TA) versus peribulbar anaesthesia (PA) for MSICS with intraocular lens (IOL) implantation.Methods: Observational study was done over a period of six months. Patients who underwent MSICS under TA and PA were prospectively evaluated for satisfaction with anaesthesia intraoperatively and four hours after surgery through a questionnaire. Any intraoperative or post-operative complications were also assessed. Surgeon satisfaction was also assessed by a questionnaire.Results: Out of 62 patients 28 underwent MSICS under TA and 34 patients under PA. There was no significant difference in age and co-morbidities between two groups. 88.24% had mild pain and 11.76% had moderate pain during PA which was statistically significant (P<0.05). 17.9% patients in TA group had mild pain at 4 hours while only 2.9% patients in PA group had pain (p<0.05). The intra operative complications were not significant. There was no statistically significant difference in post-operative complications and surgeon satisfaction between two groups.Conclusions: Although the administration of PA is painful compared to TA, the patient satisfaction was more post operatively in PA group. TA is a safe and effective alternative to PA in MSICS with proper selection and education of patient