In an ever striving drive to remain cutting edge and try new ideas, we are transitioning to topical anaesthetic instead of injections for cataract surgery.
The most common technique used for anaesthesia during cataract surgery or clear lens exchange is a peribulbar or retrobulbar injection. This is very effective but carries risks. These risks include globe perforation, accidental injection of an extraocular muscle which can result in diplopia (double vision) and of course the fear that patients have of an injection in the eye. A newer method is the use of topical (anaesthetic drops) instead. This is a more challenging method for the surgeon as the eye is mobile (unlike injections in which there is total eye immobility). It is also more challenging for patients because they are more aware of touch and the speculum which is used to hold the lids open. Despite this however patients seem to overall prefer this method. We are presently running a trial in which half our patients receive topical and the other half get the standard injections. To date the vast majority prefer topical. Once this trial is completed, we plan to publish our results.