Cataract Surgery – Anaesthetics

What kind of anaesthetic can I have for my cataract surgery?

My patients often ask me this question and it is an important aspect of cataract surgery that can sometimes be overlooked.

Today, the technique of cataract surgery has become highly efficient which has led to shorter operating times. This, in turn, has allowed for lighter forms of anaesthesia.

The primary purpose of anaesthesia in cataract surgery is to ensure that patients are comfortable during their operation and that they are relaxed enough to ensure a safe procedure.

I always discuss the variety of options available to my patients. Here is a list of anaesthetic options for cataract surgery that I offer:

Anaesthetics Overview

  • Topical anaesthesia – eye drops are given to numb the surface of the eye. This is the lightest form of anaesthesia for cataract surgery.
  • Intra-cameral anaesthesia – an infusion of anaesthetic is given into the front chamber of the eye.  It is used in combination with topical anaesthesia. This is one of the most common types of anaesthesia used in cataract surgery today. Recovery is quick with patients only needing a clear shield afterwards for a short time. I offer this type of anaesthesia approximately 90% of the time.
  • Sub-tenon’s anaesthesia – this is an infusion of anaesthetic given around the eyeball. It has a stronger numbing effect and blurs the vision. This allows sensitive patients to tolerate the brightness of the microscope light and keeps their eye from moving around. The effects of this type of anaesthesia take a few hours to wear off and an eye pad is used to protect the eye during this time.
  • Peribulbar anaesthesia – this is a needle injection of anaesthetic around the eyeball (as oppose to an infusion). This type of anaesthesia is gradually being replaced by sub- tenon’s anaesthesia. As more surgeons prefer to infuse the anaesthetic.
  • Local anaesthesia with sedation – this is a mild infusion of a sedative given into a vein of the arm to relax nervous patients. This is often used with a combination of local anaesthesia (topical or sub tenon’s). An anaesthetist is always present to monitor my patients while under sedation and to ensure full recovery before you go home. We always advise that patients are accompanied home the same day by a family member or friend.
  • General anaesthesia – patients are gently put to sleep for their cataract procedure. This is reserved for my younger patients who don’t like the idea of being awake for cataract surgery. And also for my nervous patients where sedation is still not enough to relax them. You will be fully assessed for your suitability for a general anaesthetic by our consultant anaesthetist. A consultant anaesthetist who is part of my cataract team always gives general anaesthesia. And he or she is present to monitor you during your procedure. Again we always advise that a family member or friend accompanies patients home the same day.

All my patients’ needs are different. Therefore I always fully discuss your anaesthesia options unique to your cataract surgery.

If you would like to chat further about any aspects of your cataract surgery including your particular anaesthetic options, please call me on 020 7935 7990.
I would be happy to consult with you.