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2015; Lippincott Williams & Wilkins; Volume: 41; Issue: 7 Linguagem: Inglês

10.1016/j.jcrs.2015.05.017

1873-4502

Roberto Pinto Coelho, Ricardo Hélio Biaggi, Rodrigo Jorge, Maria de Lourdes Veronese Rodrigues, André Messias,

Anesthesia and Pain Management

We are glad that Drs. Kumar and Agarwal appreciated our work and raised the question about effects of no anesthesia regarding our comparison between topical and topical with cryoanalgesia for phacoemulsification. As a matter of fact, although we knew about the interesting article describing cataract surgery without anesthesia,1 we do not have experience performing surgery with no anesthesia in our routine. Nevertheless, we agree that the factors associated with the supportable procedure without anesthesia, such as the surgeon’s skill, tissue manipulation, incision creation, and corneal innervations, are most likely to be involved with the intensity of pain during phacoemulsification. We must never ignore the following: Definitions, descriptions, and perceptions of pain and pain control are culturally specific and presumably also individually very variable. Therefore, as Drs. Kumar and Agarwal pointed out, the decision about the best anesthetic modality during phacoemulsification takes into consideration surgeon experience, patient comfort, and safety in each individual case.