A hospital-based study from India assigned 122 eyes undergoing small-incision cataract surgery to peribulbar or sub-Tenon's anaesthesia, 61 in each group. It compared pain during administration, akinesia and complications such as subconjunctival haemorrhage, chemosis and more serious events. Published in the Indian Journal of Ophthalmology on 16 October 2026.
Peribulbar injection was more painful to receive but produced more complete akinesia. Sub-Tenon's anaesthesia had a faster onset and fewer adverse events overall. The abstract does not report numerical results or confidence intervals, so the size of each difference is not known.
The study describes itself as observational with random assignment, is small and single-centre, and lacks numbers in the abstract. It is consistent with wider experience that sub-Tenon's avoids the needle-related risks of peribulbar block. The choice in SICS, which is the dominant cataract technique in many Indian centres, depends on whether the surgeon needs full akinesia.
- Consider sub-Tenon's anaesthesia for SICS when full akinesia is not essential
- Watch for chemosis and subconjunctival haemorrhage, the commonest minor complications of either block
- Choose peribulbar block when complete akinesia matters for the surgeon or the case
- Warn patients that peribulbar injection may be more uncomfortable
Why it matters
Small-incision cataract surgery is high-volume in India, so even small safety gains matter at scale.
Don't overread it
A small single-centre study whose abstract gives no numerical effect sizes.
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