title: Intraocular pressure reduction prior to retrobulbar injection of anesthetic.
abstract: Following the retrobulbar injection of anesthetic, the application of a mechanical device to lower the intraocular pressure will produce a rise in intraocular pressure that may be sufficient to compromise ocular perfusion. To increase the margin of safety for ischemic damage, a mechanical means of intraocular pressure reduction (Superpinkie) was applied prior to, rather than following, the retrobulbar injection of anesthetic. The study group consisting of 20 patients receiving the compression-injection sequence had a mean preoperative pressure of 4.70 mm Hg, while a control group of 20 patients receiving the injection-compression sequence had a mean preoperative pressure of 2.25 mm Hg. The proposed compression-injection method was well tolerated by the patients and attained surgically adequate anesthesia, akinesia, and ocular opening pressures. In selective cases, the compression-injection technique for the delivery of retrobulbar anesthesia may offer a means of better maintaining ocular perfusion and thereby lessening the risk of vascular compromise.
authors.affiliation: Department of Ophthalmology, Ottawa Civic Hospital, University of Ottawa, Canada.
authors.forename: R W
authors.initials: RW
authors.lastname: Zabel
authors.forename: W N
authors.initials: WN
authors.lastname: Clarke
authors.forename: S Y
authors.initials: SY
authors.lastname: Shirley
authors.forename: W
authors.initials: W
authors.lastname: Rock
mesh_terms: D000772:Anesthesia, Local / Q000379:methods*; D002387:Cataract Extraction; D005123:Eye / Q000098:blood supply; D006801:Humans; D007429:Intraocular Pressure; D009885:Ophthalmology / Q000295:instrumentation; D011312:Pressure