Topical anesthesia with benoxinate 0.4% for pterygium surgery

BACKGROUND AND OBJECTIVE: Anesthesia during pterygium surgery is usually achieved with injections of anesthetic medications. This study evaluated the efficacy of topical anesthesia with benoxinate hydrochloride 0.4% for pterygium surgery. PATIENTS AND METHODS: One hundred fifty consecutive patients who had primary or recurrent pterygium underwent surgical excision of the lesion. Before the surgical procedure began, each eye that was operated on received 1 drop of benoxinate hydrochloride 0.4% solution every 1 minute for 10 minutes. The pain sensation was tested with 0.12 forceps. The pterygium was dissected, and 1 or 2 conjunctival sutures were placed, leaving bare sclera. Drops of benoxinate hydrochloride 0.4% were added every 5 minutes during the operation. RESULTS: The average pterygium excision time in this study was 25 minutes. Of the 150 patients studied, only 3 required intraoperative injection of lignocaine 1%. In 2 cases, subconjunctival injection was performed, and in 1 case, retrobulbar injection was required to complete the procedure. Of the remaining 147 patients, 115 had discomfort or mild pain and asked for more anesthetics once or twice during the procedure. Postoperatively, the wounds epithelialized within 7 to 14 days in all patients, except for 2 who had postoperative dellen and 2 who received mitomycin-C postoperatively. CONCLUSION: Topical administration of benoxinate hydrochloride 0.4% provides useful anesthesia for pterygium surgery.