title: Topical versus retrobulbar anesthesia for combined phacotrabeculectomy: prospective randomized study.
abstract: OBJECTIVE
  To compare the safety and efficacy of topical and retrobulbar anesthesia for combined phacotrabeculectomy.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for combined phacotrabeculectomy.
authors.affiliation: John A. Moran Eye Center, University of Utah Health Sciences Center, Utah, Salt Lake City 84132, USA.
authors.forename: Iqbal Ike K
authors.initials: II
authors.lastname: Ahmed
authors.forename: Norman A
authors.initials: NA
authors.lastname: Zabriskie
authors.forename: Alan S
authors.initials: AS
authors.lastname: Crandall
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Burns
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Alder
authors.forename: Bhupendra C K
authors.initials: BC
authors.lastname: Patel
mesh_terms: D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002386:Cataract / Q000150:complications / Q000628:therapy; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D009915:Orbit; D018918:Phacoemulsification; D011446:Prospective Studies; D012449:Safety; D014130:Trabeculectomy; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D009883:Ophthalmic Solutions