Topical Anesthesia for Cataract Surgery Saw Increased Use Over Time

New findings suggest the use of topical anesthesia for cataract surgery increased over time in a European cohort. However, it is suggested that topical anesthesia alone had a higher risk of complications.

“The use of subtenon and regional anesthesia decreased, whereas general and combined topical and intracameral anesthesia remained stable,” wrote study author Maartje Hm Segers, University Eye Clinic, Maastricht University Medical Center.

The findings were presented at the 2022 Netherlands Ophthalmological Society Annual Congress.

Segers and colleagues aimed to determine these trends in anesthesia techniques for cataract surgery over the past decade, as well as its relationship to surgical complications. They obtained the data from the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) between January 2008 and December 2018.

The identified variables included patient demographics, visual acuity, comorbidities, surgery characteristics, intraoperative complications, and postoperative complications. Moreover, multivariate logistic regression models for each complication were constructed to estimate the adjusted odds ratio (OR) and 95% confidence intervals (CIs).

Investigators found the complete data of 1,354,036 cataract surgeries were available. Data show the number of surgeries performed with topical anesthesia increased over time (P <.001).

Specifically, the use of subtenon and regional anesthesia decreased. Meanwhile, general and combined topical and intracameral anesthesia remained stable. More data show subtenon, regional, general, and intracameral anesthesia carried a low risk of PCR compared to topical anesthesia (P <.001).

They additionally noted that the risk of dropped nucleus did not differ between anesthesia techniques and the risk of endophthalmitis was lower with regional compared to topical anesthesia (P = .001).

“Our findings suggest that topical anesthesia alone carries a higher risk of complications,” Segers concluded.

The study, “Anesthesia techniques and the risk of complications in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO),” was presented at NOG 2022.