Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr. Monali Malvankar

2nd Supervisor

Dr. William Hodge

Co-Supervisor

Abstract

Phacoemulsification is a surgical technique in which a cataract is extracted and replaced with an intraocular lens implant. This can be done under intravenous sedation, oral sedation, or no sedation, in addition to local anesthetic techniques. The purpose of this systematic review and meta-analysis is to assess the effectiveness of intravenous sedation versus non-intravenous sedation methods. Results found that intravenous sedation was significantly associated with a decrease in pain when compared to non- intravenous methods (SMD = -0.86, 95% CI 1.49 to -0.23, p=0.0008) (WMD = -1.01, 95% CI -1.66 to -0.36, p=0.002). The subgroup analysis found patients did not have a statistically significant reduction in pain when using intravenous sedation over oral sedation. The meta-analysis of perioperative complications found that intravenous sedation did not have a statistically significant increase in adverse events when compared to non-intravenous anesthesia techniques. These findings could inform policy and help develop definitive guidelines for sedation and anesthesia strategies during phacoemulsification.

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