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Abstract #6580 Published in IGR 3-2
Topical plus intracameral lidocaine versus retrobulbar anesthesia in phacotrabeculectomy: prospective randomized study
Rebolleda G; Munoz-Negrete FJ; Gutierrez Ortiz CJournal of Cataract and Refractive Surgery 2001; 27:1214-1220
PURPOSE: To compare the efficacy and safety of topical and retrobulbar anesthesia for phacotrabeculectomy. METHODS: This prospective study comprised 60 patients (60 eyes) undergoing phacotrabeculectomy surgery. Patients were randomly assigned to one of two groups receiving topical anesthesia plus intracameral lidocaine 1% or retrobulbar anesthesia. Patients were asked to document the discomfort they experienced during administration of the anesthetic agent, during surgery, and postoperatively, using a numeric pain scale. Complications and surgical conditions were also evaluated. RESULTS: The retrobulbar group reported significantly more discomfort during administration of the anesthetic agent than the topical group (p < 0.001). The topical group reported significantly more discomfort intraoperatively (p < 0.01). Eyelid squeezing and eyeball movement were more common in the topical group; however, neither was a problem to the surgeon. There was no difference in surgical conditions (p = 0.38) or in the postoperative pain scores between the two groups (p = 0.06). One patient receiving topical anesthesia developed a suprachoroidal hemorrhage intraoperatively. CONCLUSIONS: Topical anesthesia supplemented with intracameral lidocaine was an effective alternative to retrobulbar anesthesia for phacotrabeculectomy. Although the degree of patient discomfort was significantly higher during surgery under topical anesthesia, the method avoids the pain and complications associated with a retrobulbar injection.
Dr G. Rebolleda, Hospital Ramón y Cajal, Ophthalmology Department, Carretera Colmenar Viejo Kilometer 9.1, E-28034 Madrid, Spain. fjmunoz@santandersupernet.com
Classification:
12.14.3 Phacoemulsification (Part of: 12 Surgical treatment > 12.14 Combined cataract extraction and glaucoma surgery)
12.17 Anesthesia (Part of: 12 Surgical treatment)
