title: Periocular anaesthesia: technique, effectiveness and complications with special reference to postoperative ptosis.
abstract: The effectiveness of periocular anaesthesia and its complications were examined in 100 successive cataract operations. The patients were divided into 3 groups according to the duration of ocular compression with an Autopressor device after administration of periocular anaesthesia. In the control group, no compression was used (C-O, n = 36 patients). In the other two groups, compression was used for 10 (C-10, n = 32) and for 20 (C-20, n = 32) min. No differences in globe or orbicular akinesia were found between the groups. At 10 min, immobilisation of the globe in different directions was attained in 60.1-84.5% of the patients. Compression for an additional 10 min did not significantly improve the akinesia. In contrast, the hitherto undescribed loss of light perception increased with time: 15 patients at 10 min and 22 at 20 min were unable to see light. Chemosis and haematomas in the upper eyelid occurred more often in C-0 than in the other 2 groups. One day postoperatively the average palpebral aperture was smaller in C-0 than in the other two groups. The frequent postoperative ptosis (74.3% on the 1st day) decreased rapidly, but on postoperative day 7, 9 patients still had ptosis. In only one patient was ptosis still recognizable at 6 weeks postoperatively. No serious complications occurred. This study demonstrates that periocular anaesthesia with ocular compression is a suitable method for cataract surgery.
authors.affiliation: Department of Ophthalmology, Helsinki University Central Hospital, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Ropo
authors.forename: P
authors.initials: P
authors.lastname: Ruusuvaara
authors.forename: M
authors.initials: M
authors.lastname: Paloheimo
authors.forename: E L
authors.initials: EL
authors.lastname: Maunuksela
authors.forename: P
authors.initials: P
authors.lastname: Nikki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects / Q000379:methods*; D001763:Blepharoptosis / Q000209:etiology*; D002387:Cataract Extraction; D005041:Etidocaine / Q000008:administration & dosage; D005123:Eye / Q000187:drug effects; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011897:Random Allocation
chemical_list: D006821:Hyaluronoglucosaminidase; D005041:Etidocaine