CLINICAL OUTCOMES AND SAFETY PROFILE IN PHACOEMULSIFICATION: A SYSTEMATIC REVIEW COMPARING TOPICAL AND PERIBULBAR ANESTHESIA

Abstract

Phacoemulsification represents the main surgical technique employed in the treatment of cataracts, with the choice of anesthetic technique being an important factor for patient comfort, perioperative safety, and intraoperative conditions. The present study aimed to conduct a comparative systematic review between topical anesthesia and peribulbar anesthesia in phacoemulsification surgeries. To this end, searches were conducted in the PubMed, Cochrane, and Google Scholar databases, selecting 9 studies that evaluated outcomes related to pain, patient and surgeon satisfaction, hemodynamic changes, and complications associated with the anesthetic techniques. The included studies demonstrated that topical anesthesia was associated with lower pain scores during anesthetic administration and better initial patient comfort. However, in some of the studies, greater intraoperative discomfort, a higher need for anesthetic supplementation, and eventual technique conversion were observed when compared to peribulbar anesthesia. On the other hand, peribulbar anesthesia presented better results related to pain control during the surgical procedure, greater ocular akinesia, and better operating conditions reported by surgeons. Regarding safety, both techniques showed a low occurrence of severe complications in the analyzed studies. Thus, both topical anesthesia and peribulbar anesthesia demonstrated favorable results for performing phacoemulsification, and the choice of anesthetic technique should consider factors related to the patient's clinical profile, the complexity of the surgical procedure, and the surgeon's experience.