Comparative effectiveness of bilateral versus unilateral topical anesthesia in cataract surgery with hard grades of cataract by phacoemulsification technique: A focus on surgical comfort and efficiency

Abstract: AIM: This study aimed to compare the effectiveness of bilateral versus unilateral topical anesthesia in cataract surgery, with emphasis on surgical comfort and efficiency. MATERIALS AND METHODS: In this prospective, randomized controlled study, 76 patients undergoing cataract surgery with phacoemulsification were divided into two groups: Group A received unilateral topical anesthesia, and Group B received bilateral topical anesthesia. The parameters assessed were intraoperative and postoperative pain scores, surgeon comfort score, total surgical time, and the need for supplemental anesthesia. Statistical analysis was performed to compare outcomes between the two groups. RESULTS: The mean intraoperative pain scores were 0.92 ± 1.25 in Group A and 0.73 ± 1.35 in Group B ( P = 0.54). The mean postoperative pain scores were 4.784 ± 1.054 in Group A 3.321 ± 1.222 in Group B ( P = 0.66). The average surgical time was 10.54 ± 2.33 min in Group A and 9.46 ± 3.31 min in Group B ( P = 0.66). The surgeon’s comfort score was 0.34 ± 0.31 in Group A and 0.23 ± 0.23 in Group B ( P = 0.34). Supplemental anesthesia was required in two patients from Group A, and one from Group B. CONCLUSIONS: Both bilateral and unilateral topical anesthesia provided similar levels of patient comfort, surgeon comfort, and procedural efficiency during cataract surgery. The choice between bilateral and unilateral topical anesthesia can be based on surgeon preference and specific patient needs, without significantly affecting surgical outcomes or efficiency.