Effect of hyaluronidase on ocular motility and eyelid function in sub-Tenon's anaesthesia: randomised controlled trial.
OBJECTIVE
To assess the effect of hyaluronidase on eye and eyelid movements when used as an adjunct in sub-Tenon's anaesthesia.


METHODS
A total of 60 patients who had sub-Tenon's anaesthesia prior to phacoemulsification surgery were divided into two equal groups in a double-masked randomised controlled fashion. Of these, Group A had 4 ml lignocaine 2%, while Group B had 4 ml lignocaine 2% with the addition of sodium hyaluronidase 75 IU/ml. Ocular motility, levator, and orbicularis oculi function were measured in all patients at 5 and 8 min. Levator function was scored from 0 (no function) to 3 (complete function) while orbicularis function was scored from 0 to 2. The score for ocular motility was the sum in four positions of gaze, each position scoring from 0 to 2. Results were compared using a nonparametric test.


RESULTS
Group B achieved significantly better ocular and lid akinesia than Group A both at 5 and 8 min with P<0.01. The median scores for levator function at 5 and 8 min were 2 for Group A and 0 for Group B. For orbicularis function, the median scores at both time intervals were 2 for Group A and 1 for Group B. For ocular motility, the median score for Group A at 5 min was 3 and at 8 min was 2.5; for Group B at 5 min was 0.5 and at 8 min was 0.


CONCLUSIONS
The addition of hyaluronidase in sub-Tenon's anaesthesia has a significant effect in improving ocular and lid (levator and orbicularis) akinesia.
Aslam
S
S
Frimley Park Hospital, Camberley, Surrey, UK. sheraslam2@yahoo.com
Sarker
S J
SJ
Tran-Dang
M
M
Yuen
L
L
Niskopoulou
M
M
Thomas
D
D
Poole
T
T
D000759:Adjuvants, Anesthesia / Q000494:pharmacology; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000379:methods*; D001767:Blinking / Q000187:drug effects; D004311:Double-Blind Method; D005133:Eye Movements / Q000187:drug effects*; D005143:Eyelids / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000187:drug effects / Q000502:physiology
D000759:Adjuvants, Anesthesia; D006821:Hyaluronoglucosaminidase