Vitrectomy Using the Sub-Tenon's Anesthesia without Combined Anesthesia

Chung, J K; Lee, Sung Jin

Abstract

PURPOSE: The use of local anesthesia during vitreoretinal surgery has increased with improvements in technique, instrumentation, and surgical time. We report our experience of a vitrectomy under the sub-Tenon's anesthesia.
METHODS
In this prospective study, vitreoretinal pathology, intraoperative procedure, operation time, and complication were investigated between February and December 2004. To assess the efficacy of the anesthesia, patients were questioned about any pain or discomfort felt during or subsequent to their operation, and scores were assigned using a numerical rating scale (NRS). RESULT: Thirty-seven consecutive patients (37 eyes) were enrolled in this study, including fourteen patients with proliferative diabetic retinopathy, six patients with macular hole, five patients with endophthalmitis, four patients with retinal vein occlusion, four patients with aneurysm rupture, and four patients with dislocated crystalline lens. Procedures accompanying vitrectomy were membranectomy or internal limiting membrane peeling in 30 eyes, endolaser photocoagulation in 28 eyes, phacoemulsification with posterior chamber lens implantation in 16 eyes, air-fluid exchange in 10 eyes, and scleral fixation or intraocular lens in 8 eyes. The mean surgical time was 64.6+/-22.6 minutes, and pain during scleral depression was significantly greater than the others (NRS: 3.99+/-1.12, p<0.01). There were no complications during the operations, however, postoperative increased intraocular pressure was noted in four cases.
CONCLUSION
Sub-Tenon's anesthesia is safe and effective for use in vitrectomy procedures.