Ropivacaine for topical anesthesia in pterygium surgery with fibrin glue for conjunctival autograft.
OBJECTIVE
To evaluate efficacy of ropivacaine 1% for topical anesthesia in pterygium surgery with conjunctival autograft using fibrin glue for attaching the graft to the bare sclera.


METHODS
Thirty-seven patients affected by primary pterygium underwent surgical excision under topical anesthesia with ropivacaine 1%. We performed a surgical approach with dissection of the pterygium, scraping of corneal bed with a motorized burr, meticulous excision of underlying Tenon's capsule, preparation of a free autologous conjunctival graft in the superior sector, excision of the graft, and position of the same to cover the scleral bed exposed in the nasal area with respect to limbus and stromal orientation fixing the graft with fibrin glue.


RESULTS
It was possible to perform all the procedures without any supplemental anesthesia and sedation. The pain reported by patients, recorded by a 0 to 10 scale, was low during the entire surgery. The technique with conjunctival autograft using a fibrin sealant allowed for short operative times and good aesthetic and functional results.


CONCLUSIONS
Topical anesthesia with ropivacaine is safe and effective in pterygium surgery. The Long-lasting anesthesia with this agent permitted performing our surgical procedures with autograft conjunctival graft and fibrin glue to attach the flap with low pain perceived by our patients, low surgical invasivity, and short duration of surgery.
Caccavale
Antonio
A
Department of Ophthalmology, Neuro-ophthalmology and Ocular Immunology Service, Hospital C. Cantù, Abbiategrasso, Milan, Italy. neureye@katamail.com
Romanazzi
Filippo
F
Imparato
Manuela
M
Negri
Angelo
A
Porta
Alessandro
A
Ferentini
Fabio
F
D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D003228:Conjunctiva / Q000637:transplantation*; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010147:Pain Measurement; D011625:Pterygium / Q000601:surgery*; D000077212:Ropivacaine; D012590:Sclera / Q000601:surgery; D013524:Surgical Flaps; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D000077212:Ropivacaine