[Intraocular pressure and ocular hemodynamics following oculopression with and without added retrobulbar anesthesia]

Two series of experiments were performed prior to cataract surgery. In series 1, in 30 patients oculopression was performed for 15 min (30, 40 or 50 mmHg). Directly after oculopression the intraocular pressure (Pio) was found to be reduced by an average of 10.7 mmHg. Systolic retinal and ciliary perfusion pressures (measured by means of oculo-oscillodynamography according to Ulrich) were found to be increased by an average of 5.4 mmHg, and the ocular pulsation volume (PVoc) was unchanged. In series 2, we injected 5 ml of anesthetic plus adrenaline behind the eye in 20 patients, followed by 15 min of oculopression (30 or 40 mmHg). Directly after the injection, Pio was found to have increased by 3.7 mmHg, and the perfusion pressures and PVoc were reduced by an average of 8 mmHg and 51%, respectively. Directly after oculopression (15 min after injection), Pio was lower by 10.1 mmHg, but the perfusion pressures and PVoc also remained lower. The changes observed in series 1 and 2 did not depend on the amount of oculopression. We conclude that a reduction in Pio after oculopression has a beneficial effect on the ocular circulation (increased perfusion pressures), whereas retrobulbar anesthesia has an inhibitory effect (reduction of perfusion pressures and PVoc). The hemodynamic effects of oculopression are largely suppressed by additional retrobulbar anesthesia.