Assessing the analgesic benefit of phacoemulsification under topical anesthesia using pre-operative nepafenac 0.1%

Abstract

Background: To compare the intra-operative analgesic benefit of cataract surgery under topical anesthesia with and without pre-operative NSAIDs, namely nepafenac 0.1% (Alcon Laboratories Inc, Nevanec® , Fort Worth, TX, USA)

Method: In a study carried out at Mater Dei Hospital, Ophthalmic department, Malta, 199 patients with a cataract were divided into two groups. 100 eyes received nepafenac 0.1% pre-operatively while 99 eyes did not. Intra-operative discomfort was judged by assessing facial grimacing, restlessness, irritability and distress and the results were noted. Patients were divided into refractive error groups, namely myopic, hypermetropic and emmetropic.

Results: Pre-operative nepafenac 0.1% produced significantly more pain free cataract surgeries, resulting in a discomfort rate of 9% vs 28% in the group where pre-operative nepafenac 0.1% was not used. Pain was also most evidently observed on insertion of the phaco handpiece. This may be said for patients in all refractive errors groups.

Conclusions: The analgesic efficacy of nepafenac 0.1% pre-operatively is significant in reduced intra-operative discomfort during cataract surgery repair under topical analgesia.