A COMPARATIVE STUDY OF SUB TENON’S ANESTHESIA AND SUB-CONJUNCTIVAL ANESTHESIA IN MANUAL SMALL INCISION CATARACT SURGERY

Abstract

Objective: - To compare patient and surgeon comfort during SICS under sub tenon’s anesthesia (STA) and under anterior subconjunctival anesthesia (ASCA). 

Material and method: - A prospective, longitudinal study was conducted from 1^st January 2023 to 31^st July 2023 in the patients attending Ophthalmology OPD. Patients undergoing small incision Cataract surgery were randomly divided into two groups- anterior subconjunctival anesthesia (ASCA) group and sub tenon’s anesthesia (STA) group. Ocular motility, duration of surgery, pain experienced by patient and surgeon’s discomfort during surgery was recorded. 

Result: - A total of 130 patients were included in the study out of which 65 underwent SICS under ASCA and 65 underwent SICS under STA. 68(52%) were females and 62(48%) males. All patients in ASCA group had total ocular motility while in STA group 39 patients had no ocular motility, 12 each had grade 1 and grade 2 motility and 3 had grade 3 motility(p=0.001). In ASCA group in 19 cases surgeon had grade 1 discomfort, in 9 cases grade 2 while in 3 cases grade 3 discomfort in performing the surgery. In STA group only in 4 cases surgeon had grade 1 discomfort in performing the surgery with no patient with grade 2 or grade 3 discomfort. In STA group 13 patients had mild pain during the surgery while in ASCA group 35 patient had mild pain. More patients in ASCA group experienced mild pain than STA group (p<0.001) but none of the patient in any of the group had pain significant enough to need to convert to other mode of anesthesia administration. 

Conclusion: - ASCA is a feasible option in expert hands in SICS cases where patient insists on topical surgery. It obliviates the chances of needle related injury during anesthesia.