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Local anaesthesia for vitreoretinal surgery: a case-control study of 200 cases
G P Rao1, D Wong, C Groenewald
1St Paul's Eye Unit, Royal Liverpool University Hospital, UK.
Eye (London, England)
|October 17, 1998
Summary
Local anaesthesia (LA) offers a safe and efficient alternative to general anaesthesia (GA) for vitreoretinal (VR) surgery. This approach demonstrated comparable outcomes and high acceptance rates among patients and surgeons, with shorter procedure times.
Area of Science:
- Ophthalmology
- Surgical Anesthesia
Background:
- Vitreoretinal (VR) surgery in the UK predominantly uses general anaesthesia (GA).
- Local anaesthesia (LA) presents a potential alternative for VR procedures.
Purpose of the Study:
- To assess the feasibility of LA for VR surgery.
- To evaluate patient and surgeon acceptance of LA.
- To compare surgical outcomes, complications, and procedure duration between LA and GA.
Main Methods:
- A case-control study compared 100 VR surgeries under LA with 100 matched cases under GA.
- Matching criteria included surgical complexity, patient factors, and surgeon experience.
- A clinical audit assessed LA acceptability via questionnaires for 65 patients and surgeons.
Main Results:
- Similar anatomical and visual success rates were observed for both LA and GA.
- Intra-operative and post-operative complication rates were comparable between the two anaesthesia types.
- Mean surgical duration was significantly shorter under LA (p < 0.001), with high acceptance from patients and surgeons.
Conclusions:
- Vitreoretinal surgery can be performed safely and effectively using local anaesthesia.
- Implementing LA has led to increased surgical throughput.