[Topical anaesthesia in cataract surgery]

Abstract

Topical anaesthesia was introduced together with the establishment of modern cataract surgery as an operation in a closed system. Superficial anaesthesia by itself leads to a good analgesia in most cases. However, up to 30% of the patients feel uncomfortable or even experience pain during surgery. Superficial anaesthesia can be intensified with subconjunctival infiltration or by modifying the application forms such as sponges or gel. With the introduction of the intracameral anaesthesia in the 1990 s primarily with unpreserved lidocaine 1%, the efficacy of the topical anaesthesia was improved significantly. The combined topical anaesthesia plus intracameral lidocaine administration can be used as a routine method. A general anaesthesia care for premedication and monitoring during cataract surgery is useful since most cataract patients are of advanced age and frequently suffer from cardiovascular diseases. In almost 10% of the patients changes in cardiopulmonal comorbidities were observed and in 2.6% anaesthesia intervention was required.