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Related Experiment Videos

Topical anesthesia in phacotrabeculectomy.

Jimmy S M Lai1, Clement C Y Tham, Dennis S C Lam

  • 1Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong. laism@ha.org.hk

Journal of Glaucoma
|July 26, 2002
PubMed
Summary
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Topical 2% lidocaine hydrochloride jelly without systemic sedation offers a safe and effective anesthetic option for phacotrabeculectomy. This approach is suitable for patients with primary open-angle glaucoma and cataracts, demonstrating good outcomes and minimal complications.

Area of Science:

  • Ophthalmology
  • Anesthesiology

Background:

  • Cataract and primary open-angle glaucoma often require surgical intervention.
  • Combined phacotrabeculectomy addresses both conditions simultaneously.
  • Current anesthetic protocols may involve systemic sedation, posing potential risks.

Purpose of the Study:

  • To evaluate the safety and efficacy of topical anesthesia alone for phacotrabeculectomy.
  • To assess the feasibility of avoiding systemic sedation in this combined procedure.

Main Methods:

  • Prospective study involving 22 patients undergoing phacotrabeculectomy.
  • Topical 2% lidocaine hydrochloride jelly used as the sole anesthetic.
  • Intraoperative pain assessed via visual analog scale; vital signs monitored.
  • Postoperative visual acuity and intraocular pressure measured at 3 months.

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Main Results:

  • Mean intraoperative pain score was low (0.9/10), with minimal discomfort reported.
  • No supplementary anesthesia or significant changes in vital signs were noted.
  • Postoperative intraocular pressure significantly decreased (20.3 to 14.4 mm Hg).
  • Visual acuity improved in most patients; no serious complications occurred.

Conclusions:

  • Topical 2% lidocaine hydrochloride jelly without systemic sedation is a safe and effective anesthetic for phacotrabeculectomy.
  • This method is well-tolerated by patients with coexisting primary open-angle glaucoma and cataract.
  • It presents a viable alternative to traditional anesthetic approaches.