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Phacoemulsification under peribulbar: to patch or not

Poster Details

First Author: H.Vannadil INDIA

Co Author(s):    R. Goenka   S. Bhatta   J. Kaushik   A. Singh           

Abstract Details

Purpose:

To study and compare post operative outcomes of uneventful phacoemulsification cataract surgery with respect to the practice of patching and without patching.

Setting:

Military Hospital Kirkee, Pune, Maharashtra, India

Methods:

The total of 207 patients eligible to be included were alternatively assigned to ‘patch’ and ‘no patch’ groups at the culmination of the surgery on the operating table. ‘Patch’ group served as the controls (n=107) and the ‘no patch’ group served as the cases (n=100). The cases and controls underwent day-care phacoemulsification with 2.8mm multiplanar incision with two 0.9mm paracentesis under peribulbar anaesthesia. The patients were followed up on Postoperative days 1, 2 and 7. Patients with significant postoperative inflammation were followed up more frequently as per the directions of the operating surgeon.

Results:

The group without patch had significantly better distant visual acuity on the first postoperative day than the patched group (p<0.0001). The trend continued for the second postoperative day as well. However, there was no significant difference in the vision by the 7th post operative day. The corneal clarity and anterior chamber inflammation on first postoperative day showed a very significant difference between both groups with a clearer cornea and quieter anterior chamber in the non-patched group with similar findings on second day as well.

Conclusions:

Avoiding postoperative patching gives early access for the use of topical drugs leading to better postoperative outcome in immediate post operative days of cataract surgery undertaken under peribulbar anaesthesia in uneventful cases. However, the use of patching in any form did not alter the final outcome. The practice of patching may be abandoned in such cases for a faster recovery, reduced patient anxiety and reduced surgical costs.

Financial Disclosure:

None

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