Topical anesthesia with sedation in phacoemulsification and intraocular lens implantation combined with 2-port pars plana vitrectomy in 105 consecutive cases

Juan B. Yepez, Jazmin Cedeno de Yepez, Oly Azar-Arevalo, J. Fernando Arevalo, J. Fernando Arevalo

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND OBJECTIVE: To evaluate the efficacy of topical anesthesia as an alternative to peribulbar or retrobulbar anesthesia in phacoemulsification and intraocular lens implantation combined with our modified 2-port pars plana vitrectomy technique (phacovitrectomy). PATIENTS AND METHODS: Phacovitrectomy using topical anesthesia (4% lidocaine drops) was prospectively performed in 105 eyes with cataract and varied vitreoretinal pathology. In 75 eyes (71.4%), phacovitrectomy was combined with argon laser photocoagulation (endolaser). Preoperative and intraoperative sedation of varying degrees was necessary. Subjective pain and discomfort were graded from 1 (no pain or discomfort) to 4 (severe pain and discomfort). RESULTS: All patients had grade 1 pain and discomfort during most of the procedure. All patients had grade 2 (mild) pain and discomfort during pars plana sclerotomies, external bipolar cautery, and conjunctival closure. No patient required additional retrobulbar, peribulbar, or sub-Tenon's anesthesia. CONCLUSION: This technique avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye. With appropriate case selection, topical anesthesia is a safe and effective alternative to peribulbar or retrobulbar anesthesia in phacovitrectomy.

Original languageEnglish (US)
Pages (from-to)293-297
Number of pages5
JournalOphthalmic Surgery and Lasers
Volume33
Issue number4
StatePublished - Jan 1 2002

ASJC Scopus subject areas

  • Ophthalmology

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