Topical anesthesia for penetrating trabeculectomy.
OBJECTIVE
To evaluate the efficacy and clinical practicability of topical anesthesia in comparison with retrobulbar anesthesia for penetrating trabeculectomy.


METHODS
The prospective single-surgeon clinical interventional trial included 20 consecutive patients, who were randomly distributed into a topical anesthesia group ( n=10) and a retrobulbar anesthesia group ( n=10). In the topical anesthesia group, patients received preoperatively oxybuprocaine 0.4% eye drops and cocaine hydrochloride eye drops 10%. The patients of the retrobulbar group received 5 ml mepivacaine 2% injected into the retrobulbar space. To assess intraoperative pain, each patient was asked immediately after surgery to quantitate his/her pain using a 10-point pain rating scale.


RESULTS
The topical anesthesia group and the retrobulbar anesthesia study group did not vary significantly in duration of surgery (21.5+/-3.37 min vs 20.2+/-4.46 min, P=0.31), preoperative intraocular pressure (32.2+/-14.62 mmHg vs 30.6+/-12.33 mmHg, P=0.22), postoperative intraocular pressure (8.0+/-4.47 mmHg vs 9.12+/-3.13 mmHg, P=0.64), subjective pain score by the patient (2.25+/-1.23 relative units vs 2.33+/-1.08 relative units ( P= 0.71), and practicability score by the surgeon (2.24+/-1.76 vs 2.56+/-1.58, P=0.82).


CONCLUSIONS
In view of its clinical feasibility and its minimally invasive character, topical anesthesia may be an option for penetrating trabeculectomy.
Sauder
Gangolf
G
Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Gangolf.Sauder@augen.ma.uni-heidelberg.de
Jonas
Jost B
JB
D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D019162:Anesthetics, Combined / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003042:Cocaine / Q000008:administration & dosage; D005260:Female; D005901:Glaucoma / Q000601:surgery; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008619:Mepivacaine / Q000008:administration & dosage; D008875:Middle Aged; D009915:Orbit / Q000187:drug effects; D010147:Pain Measurement; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011446:Prospective Studies; D014130:Trabeculectomy
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D011343:Procaine; C005298:benoxinate; D008619:Mepivacaine; D003042:Cocaine