A comparison of topical and retrobulbar anesthesia for trabeculectomy.
OBJECTIVE
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.


METHODS
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.


CONCLUSIONS
Topical anesthesia is a safe and effective alternative to retrobulbar anesthesia for primary trabeculectomy.
Zabriskie
Norman A
NA
John A. Moran Eye Center and Department of Anesthesia, University of Utah Health Sciences Center, Salt Lake City, Utah 84132, USA.
Ahmed
Iqbal Ike K
II
Crandall
Alan S
AS
Daines
Brad
B
Burns
Thomas A
TA
Patel
Bhupendra C K
BC
D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D005260:Female; D005901:Glaucoma / Q000601:surgery*; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage; D007267:Injections; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods*; D009915:Orbit; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D011446:Prospective Studies; D012449:Safety; D014130:Trabeculectomy / Q000379:methods*
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D006821:Hyaluronoglucosaminidase; D002045:Bupivacaine