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Abstract #3638 Published in IGR 4-2
Topical anesthesia in phacotrabeculectomy
Lai JSM; Tham CCY; Lam DSCJournal of Glaucoma 2002; 11: 271-274
PURPOSE: To study the safety and efficacy of topical anesthesia alone, without systemic sedation, in phacotrabeculectomy for cataract and primary open-angle glaucoma. METHODS: In this prospective study, topical anesthesia with 2% lidocaine hydrochloride jelly without systemic sedation was used for combined phacoemulsification, posterior chamber intraocular lens implantation, and trabeculectomy in consecutive patients with primary open-angle glaucoma and concurrent cataract from September 2000 to May 2001. Visual analogue pain score and change in vital signs were used to assess the intraoperative pain experience. Other outcome measures included postoperative visual acuity and intraocular pressure at three months. RESULTS: Twenty-two eyes of 22 consecutive patients were included in the study. The mean intraoperative pain score was 0.9 (range, 0-3). Three patients reported discomfort intraoperatively. No injection of supplementary anesthetic was required in any of the eyes. None of the patients had significant increase of pulse rate or blood pressure during the whole surgical procedure. Six patients required oral analgesic for postoperative discomfort. The mean preoperative medically treated intraocular pressure (IOP) was 20.3 ± 5.9 mmHg and the mean postoperative IOP at three months was 14.4 ± 4.7 mmHg. All except two patients had improved visual acuity. There was no serious intraoperative or postoperative complication. CONCLUSIONS: Topical 2% lidocaine hydrochloride jelly without systemic sedation may be a safe and effective anesthetic method in phacotrabeculectomy for patients with primary open-angle glaucoma with coexisting cataract.
Dr. J.S.C. Lai, Department of Ophthalmology, United Christian Hospital, Hip Wo Street, Kwun Tong, Kowloon, Hong Kong. laism@ha.org.hk.
Classification:
12.17 Anesthesia (Part of: 12 Surgical treatment)