AB104. The choice of anaesthetic technique for cataract surgery

Background: Our study examined the choice of anaesthetic technique employed for cataract surgeries in the University Hospital Limerick. We looked at the number of cataract surgeries performed using the Sub-Tenon’s block technique and compared it to other methods such as peribulbar and General Anaesthesia. Sub-Tenon’s block is one of the most common techniques of orbital regional anaesthesia. It has been shown to provide effective anaesthesia to the orbit with a low incidence of sight-threatening complications when compared to sharp needle techniques. However, other methods of anaesthesia are often employed. Our study aimed to evaluate the choice of anaesthesia technique for Cataract Surgery at the University Hospital Limerick. Previous research has indicated substantial national and international variation in anaesthesia management strategies for cataract surgery. The most common forms of local anaesthesia include injection techniques (peribulbar, Sub-Tenon’s) while occasionally general anaesthesia is used. To our knowledge, this is the first study to evaluate the choice of anaesthetic technique for cataract surgery carried out in an Irish hospital setting.

Methods: We carried out a retrospective study on the choice of anaesthetic technique used for cataract surgeries carried out at the University Hospital Limerick between January and March 2019. Data was retrieved from surgical and patient records.

Results: Of 265 cataract surgeries examined, 156 (59%) were performed under Sub-Tenon’s, 99 (37%) were peribulbar, while 10 (4%) were done under general anaesthesia.

Conclusions: Sub-Tenon’s is the most popular technique of regional orbital anesthesia employed in cataract surgery. It provides adequate, safe analgesia and operating conditions, while avoiding the passage of sharp needles into the orbit. Furthermore, the risk of serious complications is much lower than other techniques of orbital regional anaesthesia. Our results show that 59% of cataract surgeries are performed under Sub-Tenon’s block technique. These results are in keeping with those from the UK in 2003 which show that Sub-Tenon’s block was used for 43% of cataract surgeries, in comparison to 31% for peribulbar and 21% for topical anesthesia.

Keywords: Cataract surgery; general anaesthesia; orbital anaesthesia; peribulbar; sub-tenons