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Abstract #15789 Published in IGR 2-3
Transient blindness after subconjunctival anesthesia for diode laser cyclophotocoagulation of advanced glaucoma
Schlote T; Freudenthaler N; von Eicken J; Rohrbach J-MKlinische Monatsblätter für Augenheilkunde 2000; 217: 296-298
BACKGROUND: Retro- and parabulbar anesthesia can be associated with severe sight-threatening and life-threatening complications and may compromise optic nerve function, especially in eyes with advanced optic neuropathy. Subconjunctival anesthesia does not usually influence optic nerve function. The authors report on two patients who developed transient amaurosis after subconjunctival anesthesia. PATIENTS: In two patients (aged 75 and 77 years) with advanced refractory glaucoma, diode laser cyclophotocoagulation was performed to lower the increased intraocular pressure (IOP). For local anesthesia, 2 ml of 2% mepivacaine was placed beneath the conjunctiva. The needle was placed at least 6 mm from the limbus to avoid bleeding at the injection site near the limbus. After ten minutes, both patients observed a decrease of vision in their treated eyes. A few minutes later, amaurosis of the treated eyes was found in both patients, which was fully reversible after two to three hours. At fundus examination, no vessel occlusion was seen. CONCLUSIONS: Subconjunctival anesthesia may cause transient blindness in patients with advanced optic neuropathy. The incidence of this side-effect seems very low.LA: German
Dr. T. Schlote, Universitäts-Augenklinik, Abteilung I, Schleichstrasse 12, 72076 Tübingen, Germany
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)
