Mechanism of Visual Sensations Experienced during Pars Plana Vitrectomy under Retrobulbar Anesthesia

2009 ◽  
Vol 224 (2) ◽  
pp. 103-108 ◽  
Author(s):  
Eiko Sugisaka ◽  
Kei Shinoda ◽  
Ronaldo Yuiti Sano ◽  
Susumu Ishida ◽  
Yutaka Imamura ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Retrobulbar Anesthesia ◽  
Pars Plana

scholarly journals 27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia

2017 ◽  
Vol 8 (1) ◽  
pp. 35-39 ◽  
Author(s):  
Zhong Lin ◽  
Nived Moonasar ◽  
Rong Han Wu ◽  
Robin R. Seemongal-Dass
Keyword(s):  
Postoperative Complications ◽  
Minimally Invasive ◽  
Pars Plana Vitrectomy ◽  
Topical Anesthesia ◽  
Retrobulbar Anesthesia ◽  
Vitreous Floaters ◽  
Pars Plana ◽  
Vitrectomy Surgery ◽  
Surgery Duration

Purpose: Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery. Method: Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported. Results: The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery. Conclusion: Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.

Anesthesia through a Novel Retrobulbar Catheter Provides Perioperative Pain Control for 24 h after Pars Plana Vitrectomy

2002 ◽  
Vol 12 (6) ◽  
pp. 512-517 ◽  
Author(s):  
J.B. Jonas ◽  
M. Jäger ◽  
T.M. Hemmerling
Keyword(s):  
Pain Control ◽  
Pars Plana Vitrectomy ◽  
Retrobulbar Anesthesia ◽  
Perioperative Pain ◽  
Numerical Scale ◽  
Catheter Technique ◽  
Retrobulbar Space ◽  
Pars Plana ◽  
Grade 3 ◽  
Age Range

Purpose The purpose of this study was to assess the retrobulbar catheter technique for perioperative pain control in pars plana vitrectomy. Methods One hundred consecutive pars plana vitrectomies (duration 20–220 minutes) in 88 patients (age range 37–88 years) were performed by the same surgeon under retrobulbar anesthesia using a commercially available retrobulbar needle. Initially, 7 ml of mepivacaine 2% were injected, a 28-gauge flexible catheter was introduced into the retrobulbar space and the needle was withdrawn. The catheter was removed 24 h after surgery. Intra-operatively and postoperatively, the patients were asked to rate pain using a numerical scale from 0 to 10. When pain was more than grade 3, 2 ml of a local anesthetic were re-injected through the catheter. Results A first re-injection was given intraoperatively 53.0 ± 34.6 minutes after the start of surgery during 35/100 procedures, and second and third injections were needed during 12/100 and 4/100 procedures, respectively. The first postoperative re-injection was given 3.9 ± 1.5 hours after the start of surgery in 54 procedures, and second and third injections were carried out in 35/100 and 10/100 procedures respectively. Conclusions The results suggest that a temporary indwelling retrobulbar catheter allows long-lasting titratable local anesthesia during pars plana vitrectomy and titratable postoperative analgesia.

scholarly journals Tonic Pupil Following Pars Plana Vitrectomy and Endolaser

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Benyamin Ebrahim ◽  
Larry Frohman ◽  
Marco Zarbin ◽  
Neelakshi Bhagat
Keyword(s):  
Retinal Detachment ◽  
Pars Plana Vitrectomy ◽  
Silicone Oil ◽  
Retrobulbar Anesthesia ◽  
Tonic Pupil ◽  
Suprachoroidal Space ◽  
Pars Plana ◽  
Silicone Oil Tamponade

Tonic pupil was observed in a 67 year-old patient following a retinal detachment repair with pars plana vitrectomy, endolaser and silicone oil tamponade performed under retrobulbar anesthesia. The probable location of disturbance is the postganglionic parasympathetic fibers in the short ciliary nerves along their course to the pupil in the suprachoroidal space. A likely explanation for this phenomenon is injury to short ciliary nerves by endolaser treatment.

Patients’ Descriptions of Visual Sensations During Pars Plana Vitrectomy under Retrobulbar Anesthesia

2007 ◽  
Vol 144 (2) ◽  
pp. 245-251 ◽  
Author(s):  
Eiko Sugisaka ◽  
Kei Shinoda ◽  
Susumu Ishida ◽  
Yutaka Imamura ◽  
Yoko Ozawa ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Retrobulbar Anesthesia ◽  
Pars Plana

Continuation of aspirin therapy before pars plana vitrectomy: Safe or not?

2020 ◽  
pp. 112067212094693
Author(s):  
Jin Wang ◽  
Qingjian Li ◽  
Yu Zhang ◽  
Xin Che ◽  
Jing Jiang ◽  
...  
Keyword(s):  
Pars Plana Vitrectomy ◽  
Vitreous Hemorrhage ◽  
Perioperative Period ◽  
Aspirin Therapy ◽  
Bleeding Complications ◽  
Control Group ◽  
Retrobulbar Anesthesia ◽  
Significant Difference ◽  
Hemorrhagic Complications ◽  
Pars Plana

Purpose: To assess the safety of pars plana vitrectomy (PPV) in patients undergoing systemic treatment with aspirin. Methods: This prospective study enrolled consecutive patients undergoing PPV under percutaneous retrobulbar anesthesia between February 2016 and July 2018. Sixty-seven eyes from 67 patients on regular aspirin therapy were randomized into two groups: the continuation group (33 eyes), with aspirin continued during the perioperative period; and the discontinuation group (34 eyes), with aspirin discontinued for 3 to 7 days before surgery. Forty-three eyes from 43 patients who had no antiplatelet/anticoagulant therapy were used as a control group. Results: There was no significant difference in the incidence of hemorrhagic complications or the need for additional operations due to hemorrhagic complications among the three groups ( p = 0.740 and p = 0.324, respectively). None of the patients in these three groups suffered from thromboembolic events during the follow-up period. Except for one case (3.0%) of lid ecchymosis in the continuation group, no eye experienced bleeding complications associated with the retrobulbar local anesthesia. In the continuation group, three eyes (9.1%) demonstrated postoperative hyphema that resolved spontaneously. In the discontinuation group, two eyes (5.9%) suffered from postoperative vitreous hemorrhage, of which one eye required secondary surgery and the other cleared spontaneously. One eye (2.9%) in the discontinuation group demonstrated postoperative hyphema that absorbed spontaneously. Three eyes (7.0%) in the control group experienced hyphema that absorbed spontaneously. Conclusion: The outcomes of our study indicate that PPV under retrobulbar anesthesia can be safely performed without discontinuing systemic aspirin therapy.

Transscleral Extraction of an Intraocular Foreign Body From the Posterior Segment of the Eye Without Pars Plana Vitrectomy

2020 ◽  
Vol 76 (1) ◽  
pp. 14-23
Author(s):  
Štěpán Rusňák ◽  
Lenka Hecová
Keyword(s):  
Foreign Body ◽  
Pars Plana Vitrectomy ◽  
Young Patients ◽  
Vitreous Body ◽  
Visual Control ◽  
Intraocular Foreign Body ◽  
Survey Study ◽  
Surgical Method ◽  
Eye Trauma ◽  
Pars Plana

Purpose: Penetrating eye trauma with an intraocular foreign body is very frequent, especially in men in their productive age. Pars plana vitrectomy would be the standard surgical method at our department. However, in indicated cases (metallic intraocular bodies in the posterior eye segment in young patients with well transparent ocular media without detached ZSM and without any evident vitreoretinal traction) transscleral extraction of the intraocular foreign body is performed using the exo magnet, eventually endo magnet with a minimal PPV without PVD induction under the visual control of endo-illumination. Materials and Methods: Between June 2003 and June 2018, 66 eyes of 66 patients diagnosed with a penetrating eye trauma caused by an intraocular foreign body located in the posterior eye segment were treated. In 18 eyes (27,3 %) with a metallic foreign body in vitreous (body) or in retina, no PPV or a minimal PPV without PVD was used as a surgical method. In the remaining 48 eyes (72,7 %), a standard 20G, respectively 23G PPV method were used together with PVD induction and the foreign body extraction via endo or exo magnet. Conclusions: As demonstrated by our survey/study, in the cases of a thoroughly considered indication an experimented vitreoretinal surgeon can perform a safe NCT transscleral extraction from the posterior eye segment via exo magnet, eventually endo magnet under the visual control of a contact display system with a minimal PPV. Thereby, the surgeon can enhance the patient´s chance to preserve their own lens and its accommodative abilities as well as reduce the risk of further surgical interventions of the afflicted eye.

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