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Subjective visual perceptions during vitreoretinal surgery under local anaesthesia.

S B Vohra1, C Anya, T Farooq

  • 1Birmingham and Midland Eye Centre, City Hospital, Birmingham, UK.

Eye (London, England)
|October 25, 2008
PubMed
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Most patients undergoing vitreoretinal surgery under local anaesthesia (LA) report visual experiences like light and movement. While generally bearable, forewarning patients about these common intraoperative perceptions can improve their comfort.

Area of Science:

  • Ophthalmology
  • Surgical Anesthesia

Background:

  • Vitreoretinal surgery is increasingly performed under local anaesthesia (LA).
  • Understanding patient visual experiences during LA is crucial for improving patient care and managing expectations.

Purpose of the Study:

  • To evaluate the nature and prevalence of visual experiences in patients undergoing vitreoretinal surgery under local anaesthesia (LA).

Main Methods:

  • A prospective questionnaire survey was conducted on 80 patients immediately after vitreoretinal surgery under LA.
  • Data collected included preoperative visual acuity, surgical details, local block efficacy, and intraoperative visual perceptions (light, colours, movements, flashes, instruments).

Main Results:

  • 90% of patients perceived light, with many observing movements (70.8%), colours (62.5%), instruments (52.8%), and flashes (33.3%).

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  • Common observations included colourful swirls and seeing instruments. Most experiences were deemed pleasant or bearable.
  • Younger patients were more likely to report flashes and seeing instruments. Sub-Tenon's block was associated with light perception, and lack of sedation with seeing instruments.

    • Conclusions:

    • Visual experiences are a common occurrence during vitreoretinal surgery performed under local anaesthesia.
    • Patients should be appropriately forewarned about potential intraoperative visual perceptions and reassured of their generally benign nature.