Lennox A. Webb

Management of traumatic aniridia and aphakia with an iris reconstruction implant

We describe the clinical features and management of a 36-year-old man with aniridia and aphakia following blunt ocular trauma. Examination showed partial aniridia and aphakia. We discuss the various options available in the management of this patient and describe the surgical technique involved in the implantation of an iris reconstruction implant.

Surgeon experience and patient comfort during clear corneal phacoemulsification under topical local anesthesia

Purpose: To evaluate patient comfort during topical anesthesia clear corneal phacoemulsification surgery performed by a surgeon in the learning curve or by an experienced surgeon. Setting: Royal Alexandra Hospital, Paisley, Scotland, United Kingdom. Methods: This study comprised 46 consecutive patients having phacoemulsification under topical anesthesia of proparacaine 0.5% (Proxymetacaine®). Surgery was performed by a surgeon during his learning curve (n = 20) or by an experienced surgeon (n = 26). No sedation or intracameral anesthesia was used in either group. All patients had clear corneal phacoemulsification with foldable acrylic posterior chamber intraocular lens implantation. Each patients subjective experience of overall pain perioperatively (period immediately surrounding and during surgery) and worst pain perceived during surgery was measured immediately after surgery using a 10‐point visual analog scale. Results: There was no significant difference in patient‐reported pain scores for overall pain perioperatively (P = .47, Wilcoxon rank sum test) and the worst pain perceived during surgery (P = .32, Wilcoxon rank sum test). Conclusions: Topical anesthesia with proparacaine provided similar and reasonable analgesic effects in patients having surgery by a surgeon in the learning curve and those having surgery by an experienced surgeon. The discomfort perceived during surgery performed by an experienced surgeon was less, although not statistically significantly different.