Practice preferences of ophthalmic anaesthesia for cataract surgery in Singapore

Wagle AA, Wagle AM, Bacsal K, Tan CSH, Chee SP, Au Eong KG
Correspondence: Dr Ajeet M Wagle, ajeet_wagle@alexhosp.com.sg

ABSTRACT
Introduction This study aims to describe the preferences of ophthalmic anaesthesia for cataract extraction among ophthalmologists in Singapore.
Methods A nationwide questionnaire survey of all cataract surgeons in institutional and private practice in Singapore was conducted in August 2004.
Results The response rate was 61.1 percent (88 out of 144 eligible ophthalmologists surveyed). Phacoemulsification was the preferred surgical technique for 92 percent of the respondents while extra-capsular cataract extraction was preferred by eight percent. For all surgeons performing phacoemulsification, the anaesthesia technique of choice was peribulbar anaesthesia for 43 percent, topical anaesthesia for 42 percent, retrobulbar anaesthesia for 13 percent, and sub-tenons and general anaesthesia for one percent each of the respondents. For all the surgeons performing extra-capsular cataract extraction, the preferred anaesthetic technique was peribulbar anaesthesia for 69 percent, retrobulbar anaesthesia for 30 percent and sub-tenons anaesthesia for one percent of the respondents. The surgeons' main reasons for choosing a specific anaesthesia modality for their surgery were patient comfort and surgeon's choice. The majority of surgeons used mild sedation and monitored anaesthesia care for their cataract surgeries.
Conclusion Peribulbar anaesthesia is currently the preferred anaesthesia technique for both phacoemulsification and extra-capsular cataract extraction in Singapore. Topical anaesthesia closely follows peribulbar anaesthesia as a preferred choice for phacoemulsification.

Keywords: cataract extraction, extra-capsular cataract extraction, ophthalmic anaesthesia, phacoemulsification
Singapore Med J 2007; 48(4): 287–290