Subconjunctival anesthesia in contact diode laser cyclophotocoagulation.

Area of Science:

• Ophthalmology
• Surgical Anesthesia

Background:

• Traditional retro- or peribulbar anesthesia for cyclodestructive surgery may risk optic nerve function, particularly in advanced glaucoma.
• Subconjunctival anesthesia is explored as a safer alternative for contact diode laser cyclophotocoagulation (CPC).

Purpose of the Study:

• To evaluate the efficacy and safety of subconjunctival anesthesia in patients undergoing contact diode laser CPC for advanced glaucoma.
• To assess pain levels and complications associated with subconjunctival anesthesia during CPC.

Main Methods:

• A prospective study involving 120 eyes of 120 patients with advanced glaucoma.
• Subconjunctival anesthesia using 2% mepivacaine was administered prior to contact diode laser CPC.
• Pain was recorded on a 5-point rating scale during the procedure and on the first postoperative day.

Main Results:

• 82.5% of patients reported no pain during CPC, 11.7% experienced mild pain, and 5.8% reported moderate pain.
• No cases required conversion to peribulbar anesthesia or procedure discontinuation due to pain or motion.
• The procedure was successfully completed in all patients without significant complications.

Conclusions:

• Subconjunctival anesthesia is a well-tolerated and effective anesthetic technique for contact diode laser CPC.
• This method successfully avoids the risks and side effects associated with retro- or peribulbar anesthesia.
• Subconjunctival anesthesia represents a simple yet significant modification for improving patient comfort and safety in CPC procedures.