Comparison of topical anesthesia and peribulbar anesthesia for 23-gauge vitrectomy without sedation

To compare the safety and efficacy of topical anesthesia versus peribulbar anesthesia for 23-gauge vitrectomy without sedation.

Selected group of 60 patients with vitreous hemorrhage were divided into 2 groups and underwent 23-gauge vitrectomy. Group 1 used topical anesthesia, whereas Group 2 used peribulbar anesthesia. A 5-point Visual Analogue Scale was used to assess patients' pain score and surgeon's ease while operating. Any complications thereof were made note of.

Mean overall patients' pain scores were 1.77 ± 0.50 in Group 1 and 1.77 ± 0.43 in Group 2. Surgeon's comfort score was recorded as 0.3 ± 0.53 and 0.17 ± 0.38 in Groups 1 and 2, respectively. Mean surgical time was 33.7 ± 7.1 minutes and 30.1 ± 6.2 minutes in Groups 1 and 2, respectively. These means were not statistically significant (P > 0.05). No patient required sedation or anesthesia supplementation. Group 1 patients reported maximum pain during trocar entry, whereas Group 2 reported maximum pain during block. Group 2 patients also reported significant conjunctival chemosis and lid edema postblock.

Topical anesthesia without any sedation is a viable option, comparable to peribulbar block, for performing vitrectomy in selected group of patients requiring vitrectomy and thus avoiding complication of injection anesthesia and quicker postoperative recovery.