Topical anesthesia in transconjunctival sutureless 25-gauge vitrectomy for macular-based disorders.
OBJECTIVE
To evaluate the safety and feasibility of topical anesthesia in vitrectomy using the transconjunctival sutureless 25-gauge system (TSV 25G).


METHODS
TSV 25G vitrectomy was performed prospectively in 46 eyes of 46 patients with macular-based disorders, including macular holes (n = 31), idiopathic epiretinal membranes (n = 11), and vitreoretinal traction syndrome (n = 4). Topical anesthesia was administered in each patient by instilling 2% Alcaine at 5 min intervals, three times before surgery. Additional Alcaine drops were given as a supplementation if needed during the operation. The levels of intraoperative analgesia were graded from 1 (adequate) to 3 (inadequate).


RESULTS
Thirty-one patients (67.4%) tolerated the procedure well, with no additional anesthetic agent. Thirteen patients (28.3%) required additional topical anesthesia and 2 patients (4.3%) required a systemic sedative. Intraoperative pain occurred when the sclera was pierced by the microcannula and when sclera indentation was performed. No patient required additional retrobulbar or peribulbar anesthesia. There was no intraoperative complication which was specifically related to topical anesthesia.


CONCLUSIONS
Topical anesthesia permits the successful management of some surgically less complex vitreoretinal disorders when the TSV 25G is used.
Tang
Shibo
S
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China. tangs6@mail.sysu.edu.cn
Lai
Pinghong
P
Lai
Mingying
M
Zou
Yuping
Y
Li
Jiaqing
J
Li
Shuangnong
S
D000328:Adult; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011430:Propoxycaine / Q000008:administration & dosage*; D011446:Prospective Studies; D012164:Retinal Diseases / Q000601:surgery*; D013536:Suture Techniques; D014821:Vitrectomy
D000779:Anesthetics, Local; C005717:proxymetacaine; D011430:Propoxycaine