Evaluation of deep topical fornix block versus topical anesthesia in patients undergoing implantable collamer lens procedure

Background and aim
Local anesthesia nowadays became more popular in the ophthalmic surgery, especially in implantable collamer lens (ICL) procedure, with fewer complications and more patient satisfaction. Here we design a study to evaluate deep topical fornix nerve block (DTFNBA) versus topical anesthesia.
Methods
A double blinded randomized prospective controlled study of 107 eyes that were scheduled for implantable collamer lens procedure was included and divided randomly into two groups, group I topical anesthesia ( = 53), group II DTFNBA ( = 54). The two groups were monitored for pain and patient compliance.
Results
In group I, receiving topical anesthesia 27 patients (50.09%) reported pain, especially with implantation of the lens, tucking of the lens footplates and peripheral iridectomy that necessitated intracameral lidocaine injection. The others ( = 26) showed different grades of discomfort that was tolerated without the need for intracameral lidocaine. 40 patients (74.07%) in group II (DTFNBA), tolerated the surgery well, and slight discomfort was reported as a sensation of heaviness during the tucking of footplates. None of the patients had pain strong enough to require intracameral injection of lidocaine ( < 0.05).
Conclusions
Placing the anesthetic in the fornix makes the DTFNBA more effective and reliable block.