ABSTRACT
PURPOSE: To compare the safety and efficacy of topical versus retrobulbar anesthesia for primary trabeculectomy METHODS: A prospective study of 36 consecutive patients undergoing trabeculectomy who were randomized to receive topical (n = 18) or retrobulbar (n = 18) anesthesia. Operating conditions, patient comfort, and surgical outcome were evaluated. SETTINGS: Tertiary-care university hospital ambulatory surgical center. RESULTS: There were no differences in operating conditions (P = 0.14), pain during (P = 0.54) or after (P = 0.76) surgery, or supplemental anesthesia required (P = 0.34) between the two groups. Very few patients in either group were bothered by touch sensation, tissue manipulation, or the microscope light. Chemosis, subconjunctival hemorrhage and eyelid hemorrhage were seen exclusively in the retrobulbar group (P <0.03), and were all attributable to the injection. Inadvertent eye movement was present more frequently in the topical group (P = 0.01), although this did not pose a problem to the surgeon. No surgical complications were encountered in either group. CONCLUSION: Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for primary trabeculectomy.
Subject(s)
Anesthesia, Local/methods , Anesthetics, Combined/administration & dosage , Anesthetics, Local/administration & dosage , Glaucoma/surgery , Nerve Block/methods , Trabeculectomy/methods , Aged , Aged, 80 and over , Bupivacaine/administration & dosage , Female , Humans , Hyaluronoglucosaminidase/administration & dosage , Injections , Lidocaine/administration & dosage , Male , Middle Aged , Orbit , Pain Measurement , Pain, Postoperative/diagnosis , Prospective Studies , SafetyABSTRACT
PURPOSE: To compare the safety and efficacy of topical and retrobulbar anesthesia for combined phacotrabeculectomy. SETTING: Tertiary-care university hospital ambulatory surgical center. METHODS: In this prospective study, 40 consecutive patients having combined phacotrabeculectomy were randomized to receive topical (n = 20) or retrobulbar (n = 20) anesthesia. Operating conditions, patient comfort, and surgical outcome were evaluated. RESULTS: There was no significant between-group difference in operating conditions (P =.56), pain during (P =.41) or after (P =.23) surgery, or supplemental anesthesia required (P =.49). Few patients in either group were bothered by tissue manipulation or the microscope light, although more patients in the topical group were slightly bothered by touch sensation (P =.05). Chemosis, subconjunctival hemorrhage, and eyelid hematoma were seen almost exclusively in the retrobulbar group (P <.05). Inadvertent eye movement was present more frequently in the topical group (P =.04), although this did not pose a problem to the surgeon. CONCLUSION: Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for combined phacotrabeculectomy.