Indicators of patient suitability for topical anesthesia

Indicators of patient suitability for topical anesthesia

To determine whether a patient's suitability for phacoemulsification under topical anesthesia can be predicted preoperatively by their performance during tonometry and A-scan. Whipps Cross Hospital Ophthalmology Department, London, England. Fifty consecutive patients who were considered suitabl...

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Bibliographic Details
Published in:Journal of cataract and refractive surgery Vol. 23; no. 5; p. 781
Main Authors: Fraser, S G, Siriwadena, D, Jamieson, H, Girault, J, Bryan, S J
Format: Journal Article
Language:English
Published: United States 01-06-1997
Subjects:
Administration, Topical
Aged
Aged, 80 and over
Anesthesia, Local - methods
Anesthetics, Local - administration & dosage
Female
Humans
Intraocular Pressure
Lenses, Intraocular
Male
Middle Aged
Ophthalmic Solutions
Patient Compliance
Patient Selection
Phacoemulsification - methods
Prospective Studies
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Summary:To determine whether a patient's suitability for phacoemulsification under topical anesthesia can be predicted preoperatively by their performance during tonometry and A-scan. Whipps Cross Hospital Ophthalmology Department, London, England. Fifty consecutive patients who were considered suitable for phacoemulsification were selected for the study. Using a scoring system we devised, observers assessed the patients for the ease with which intraocular pressure and axial length were measured. These scores were compared with an assessment of how well they tolerated phacoemulsification under topical anesthesia. Correlation between the scores was measured with Spearman's rank correlation coefficient, Kendall's rank correlation coefficient, and the Goodman-Kruskal gamma statistic. Phacoemulsification and posterior chamber intraocular lens implantation were completed in all patients. Statistical analysis showed that tonometry and A-scan scores correlated highly with surgery scores. Age was also a significant variable in predicting the surgery score. A significant discrepancy between tonometry and A-scan and surgery scores was found in only one patient, and it was noted that he was one of the youngest patients in the study. How well a patient performs during tonometry and A-scan was a good predictor of how well he or she tolerated having phacoemulsification under topical anesthesia. The decision about type of anesthesia should, however, also involve other factors, including communication, cooperation, and the age of the patient.
ISSN:0886-3350
DOI:10.1016/S0886-3350(97)80290-8