Effect of Honan balloon compression on peribulbar anesthesia adequacy in cataract surgery

To ascertain whether a Honan balloon is necessary to produce effective peribulbar anesthesia in routine cataract surgery by evaluating its effect on intraocular pressure (IOP), surgeon assessment of the anesthesia's effectiveness, and patients' analgesic experience.

West of England Eye Unit, Royal Devon and Exeter Hospital, England.

Fifty eyes of 50 patients having routine phacoemulsification cataract extraction and intraocular lens implantation were randomized to have 10-minute ocular compression with the Honan balloon or no compression after peribulbar anesthesia. A single investigator gave all the peribulbar injections using a standard technique. The IOP was measured immediately before and 10 minutes after the injections. Two surgeons who were blinded to the randomization process performed the surgeries and completed an assessment questionnaire on various aspects of the peribulbar block. The patients also scored their level of analgesia during surgery.

In the 26 patients who had Honan balloon compression, there was a significant reduction in IOP (mean 6.2 mm Hg; P <.05). In the 24 patients with no balloon compression, there were no significant changes in IOP 10 minutes after the peribulbar injections. There was no statistically significant difference in the surgeons' scores in any aspect of the peribulbar anesthesia (P >.05). All patients experienced a good level of analgesia.

There was a significant reduction in IOP after Honan balloon ocular compression. However, there was no significant increase in IOP without balloon compression. The use of a Honan balloon did not appear to make a significant difference in the effectiveness of the peribulbar anesthesia to the surgeons or patients.