Publication Date
6-1-2022
Journal
Journal of Cataract & Refractive Surgery
DOI
10.1097/j.jcrs.0000000000000860
PMID
34753878
PMCID
PMC9119400
PubMedCentral® Posted Date
11-12-2021
PubMedCentral® Full Text Version
Post-print
Published Open-Access
yes
Keywords
Analgesics, Opioid, Anesthesia, Local, Anesthetics, Local, Cataract, Humans, Ophthalmology, Pain, Pain Management, Pain, Postoperative
Abstract
Cataracts are a leading cause of preventable blindness globally. Although care varies between developing and industrialized countries, surgery is the single effective approach to treating cataracts. From the earliest documented primitive cataract removals to today's advanced techniques, cataract surgery has evolved dramatically. As surgical techniques have developed, so have approaches to surgical pain management. With current cataract surgical procedures and advanced technology, anesthesia and intraoperative pain management have shifted to topical/intracameral anesthetics, with or without low-dose systemic analgesia and anxiolysis. Despite this, pain and discomfort persist in some patients and are underappreciated in modern cataract surgery. Although pain management has progressed, opioids remain a mainstay intraoperatively and, to a lesser extent, postoperatively. This article discusses the evolution of pain management in cataract surgery, particularly the use of opioids and the associated risks as well as how ophthalmology can have a positive impact on the opioid crisis.