title: General anesthesia versus local anesthesia for penetrating keratoplasty: a prospective study.
abstract: OBJECTIVE
  To examine which anesthesia general or local is more effective for penetrating keratoplasty (PKP).
  
  
  METHODS
  Patients with indications for PKP (n=141) were enrolled in a prospective study and randomly divided into general anesthesia group (group A, 70 eyes) and local anesthesia group (group B, 71 eyes). Patients received optical PKP (group A1, 30 eyes; group B1, 30 eyes) or therapeutic PKP (group A2, 40 eyes; group B2, 41 eyes). Measurement of anterior chamber treatment time (T) for PKP patients and the ratio (R) of the area of the pupils to that of recipient graft region. T and R values, as well as perioperative and postoperative complications, were compared between groups A and B using t-test or χ (2) test.
  
  
  RESULTS
  Patients were followed for 2wk after PKP. T was (13.45±8.64)min for group A and (7.36±5.24)min for group B, a statistically significant difference (P<0.001). The R value for group A was stable during the operation, while for PKP patients in group B the value initially increased then gradually decreased to normal after suturing. In group B, extrusion of intraocular contents occurred in 5 eyes, and iridal prolapse occured in 11 cases; no perioperative complications occurred in group A. Relapse rate for fungal keratitis was 13.04% in group B and 0% in group A.
  
  
  CONCLUSIONS
  Under general anesthesia, pupils remaine stable during PKP and perioperative complications are averted. General anesthesia gives more time to treat pathological changes in the anterior chamber and treatment success rate is higher.
authors.affiliation: Department of Ophthalmology, Qianfoshan Hospital, Medical School of Shandong University, Jinan 250014, Shandong Province, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Ophthalmology, Qianfoshan Hospital, Medical School of Shandong University, Jinan 250014, Shandong Province, China.
authors.forename: Guang-Fu
authors.initials: GF
authors.lastname: Dang
authors.affiliation: Department of Ophthalmology, Jinan No.2 Hospital, Jinan 250001, Shandong Province, China.
authors.forename: Ying-Mei
authors.initials: YM
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Jinan No.2 Hospital, Jinan 250001, Shandong Province, China.
authors.forename: Wei-Fan
authors.initials: WF
authors.lastname: Li
authors.affiliation: Department of Ophthalmology, Qilu Hospital, Medical School of Shandong University, Jinan 250012, Shandong Province, China.
authors.forename: Xin-Yi
authors.initials: XY
authors.lastname: Wu
keywords: general anesthesia; local anesthesia; penetrating keratoplasty