Topical Anesthesia for Cataract Surgery: a Population-based Perspective

Purpose: To analyze the anesthetic regimen and sedation in a population-based cohort of unselected cataract surgery cases operated on with the goal of maximizing the percentage of patients with topical anesthesia and no sedation.

Setting: Department of Ophthalmology, Norrlands University Hospital, Umeå, Sweden.

Methods: This prospective observational population-based study comprised all patients having cataract surgery during a 1 year period at 1 institution. Data were collected from the patients' records, which were standardized. Outcome measures were use of preoperative sedation, type of anesthesia, intraoperative complications, and adverse events.

Results: The study comprised 890 cases performed by 4 surgeons. Seventy-two percent of patients had no sedation and topical anesthesia only. All patients except 1 who had previous cataract surgery with topical anesthesia chose the same method for their second-eye surgery. The rate of posterior capsule rupture was in the expected range for a population with high incidences of pseudoexfoliation and mature cataract.

Conclusions: It is possible to achieve a high percentage of effective topical anesthesia for cataract surgery in a population-based setting. The findings have implications for cost-containment in health services.