2018, Vol. 1, Issue 2, Part A

Background: Cataract surgery is one of the most frequently performed ophthalmic procedures worldwide. Effective regional anesthesia is vital to ensure patient comfort, minimize complications, and optimize surgical outcomes. Peribulbar and retrobulbar anesthesia are two commonly employed techniques, each with distinct anatomical targets, risk profiles, and clinical efficacy. This study compares the effectiveness and complication rates of these two modalities in patients undergoing cataract surgery.

Materials and Methods: A prospective, comparative observational study was conducted in the Department of Ophthalmology, Sree Balaji Medical College and Hospital, Chennai, from October 2017 to September 2018. One hundred patients scheduled for phacoemulsification were randomized into two groups: Group A (Peribulbar, n=50) and Group B (Retrobulbar, n=50). Pain scores, akinesia, onset time, duration of anesthesia, and intraoperative and postoperative complications were evaluated. Statistical analyses included chi-square tests and independent t-tests, with a significance threshold of p<0.05.

Results: Peribulbar anesthesia achieved complete akinesia in 86% of patients, compared to 92% in the retrobulbar group. Mean onset of anesthesia was longer in the peribulbar group (4.8±1.2 min vs. 2.9±0.9 min; p=0.001), but pain scores were significantly lower (VAS: 1.8±0.6 vs. 2.4±0.7; p=0.002). Complication rates were higher in the retrobulbar group, particularly globe perforation (4%) and retrobulbar hemorrhage (6%).

Conclusion: While retrobulbar anesthesia provides faster onset and marginally better akinesia, peribulbar anesthesia is associated with fewer complications and superior patient comfort, making it a safer alternative in cataract surgery.