Topical anaesthesia using eye drops alone compared with a combination of eyedrops and anaesthesia within the eye for cataract surgery

There are many different options for anaesthesia during cataract surgery. Using anaesthetic eye drops (topical anaesthesia) has become an increasingly popular option in modern, rapid-turnover day case cataract surgery as it is minimally invasive, cost effective, less prone to complications and provides for faster patient rehabilitation. Many surgeons who use topical anaesthesia supplement this with anaesthetic administered within the eye (intracameral) during the surgery. This review has found that the use of intracameral lidocaine as a supplement to topical anaesthesia significantly reduces intraoperative pain perception when compared to the use of topical anaesthesia alone. No significant difference was demonstrated between the groups receiving topical anaesthesia alone and topical eye drops combined with intracameral anaesthesia in terms of the need for supplemental anaesthesia, intraoperative adverse events or corneal toxicity. We conclude that the administration of intracameral anaesthetic during surgery is an effective and safe supplementation to topical anaesthesia.