Cataract is the commonest cause of reversible blindness and cataract surgery is the commonest ophthalmic surgery performed worldwide. Over the years, cataract surgery has undergone tremendous technical advancements which have made the surgery safe and effective than ever before. Today, with small incision cataract surgery and foldable intra-ocular lens (IOL), not only have patient’s postoperative expectations raised, perioperative experience has improved too. The western ophthalmology practice has observed a shift in the anaesthesia technique during cataract surgery over the last decade. From a predominant peribulbar and retrobulbar anaesthesia, today more and more cataract surgeries are now performed under topical-intracameral anaesthesia. A major cause for such a shift has been a higher associated vision and life threatening complication rate with peri-bulbar and retro-bulbar techniques. Secondly, the need of akinesia during surgery to prevent squeezing of extra-ocular muscles and expulsion of globe contents has been reduced with small incisions. Today, medical literature conclusively points to the safety and efficacy of topical anaesthesia in routine cataract surgery practice.

1.  Gupta SK, Kumar A, Sharma AK, Agrawal S, Katiyar V, et al. (2015) Topical anesthesia in high volume cataract surgery: Pain evaluation and feasibility study. J Anesth Clin Res 6: 582.