• Y Tokuda, T Oshika, S Amano, J Inouye, and F Yoshitomi.
• Inouye Eye Hospital, Tokyo, Japan.
• Graefes Arch. Clin. Exp. Ophthalmol. 2000 Mar 1; 238 (3): 228-31.

BackgroundA prospective study was conducted to compare the analgesic effects of sub-Tenon's and retrobulbar anesthesia by assessing patients' response to the visceral stimulus.MethodsSeven hundred and twenty eyes of 720 patients underwent extracapsular cataract extraction and posterior chamber intraocular lens implantation. They received retrobulbar anesthesia with 3 ml lidocaine (225 eyes), retrobulbar anesthesia with 5 ml lidocaine (216 eyes), or sub-Tenon's anesthesia with 3 ml lidocaine (279 eyes). Pain scores were recorded when an acetylcholine chloride solution was injected into the anterior chamber to attain miosis after lens implantation.ResultsPain scores were significantly different among the three anesthesia groups (P<0.0001, Kruskal-Wallis test). The multiple comparison revealed that analgesic effects were highest with sub-Tenon's anesthesia, followed by 5-ml retrobulbar and 3-ml retrobulbar anesthesia.ConclusionSub-Tenon's anesthesia is an effective and reliable anesthetic method in cataract surgery.

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