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Subconjunctival versus peribulbar anesthesia in trabeculectomy: a prospective, randomized study

A Azuara-Blanco¹, M R Moster, B P Marr

¹Glaucoma Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA 19107, USA.

Ophthalmic Surgery and Lasers

|December 5, 1997

Summary

Subconjunctival anesthesia provides effective pain control and is a viable alternative to peribulbar anesthesia for trabeculectomy surgery, with similar outcomes and minimal complications.

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Area of Science:

Ophthalmology
Anesthesiology

Background:

Trabeculectomy is a common glaucoma surgery.
Anesthesia choice impacts surgical outcomes and patient comfort.

Purpose of the Study:

To compare the efficacy and safety of subconjunctival anesthesia versus peribulbar anesthesia in patients undergoing trabeculectomy.

Main Methods:

Prospective randomized trial involving 60 patients undergoing trabeculectomy.
Comparison of peribulbar (mepivacaine, bupivacaine, hyaluronidase) and subconjunctival (same mixture without hyaluronidase) anesthesia.
Evaluation of intraoperative pain, eye movements, and complications.

Main Results:

Pain frequency and intensity were similar between subconjunctival and peribulbar anesthesia groups, with all reported pain being mild.

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Increased eye movements were observed in the subconjunctival group but were manageable and did not impede surgery.

No significant intraoperative complications were noted in either group.

Conclusions:

Subconjunctival anesthesia is an effective and safe alternative to peribulbar anesthesia for trabeculectomy.
This technique offers comparable outcomes with a similar safety profile.