Peribulbar block for corneal transplantation: efficacy and safety

Background: The quality of ophthalmic anesthesia is an important component of the surgical procedure. There is no absolutely well-tolerated local eye anesthetic technique. However, it is important to choose a technique with high efficacy and safety. Objective: This study aimed to compare the efficacy and safety of peribulbar block using medial canthus single injection and posterior sub-tenon injection techniques. Methods: This prospective observational study was carried out at the Research Institute of Ophthalmology, Cairo, Egypt during the period from March to December 2018. Consecutive 60 patients of both sexes, aged >18 years-old, scheduled for bilateral strabismus surgery were enrolled in this study. In one eye of the sixty patients, medial canthus single injection peribulbar anesthesia was used (Group A), whereas posterior sub-tenon technique was applied in the other eye (Group B). Results: The median total ocular akinesia score was significantly higher in group A than in group B when assessed at 1, 3, and 5 min (p < 0.001). Each of the intraoperative (at 5 min) and postoperative pain scores showed no significant differences between the two groups (p > 0.05). However, the median scores of surgeon and patient satisfaction were significantly higher in group A compared with group B (3 vs. 2 each, p < 0.05). No patient developed occulocardiac reflex or postoperative nausea and vomiting. Conclusion: Peribulbar anesthesia by medial canthus single injection showed better akinesia of the globe than sub-tenon injection technique. Otherwise, both techniques were equally effective and safe.

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Efficacy and safety of dexmedetomidine as an additive to local anesthetics in peribulbar block for cataract surgery

Anesthesia Essays and Researches ◽

10.4103/0259-1162.113987 ◽

2013 ◽

Vol 7 (1) ◽

pp. 39 ◽

Cited By ~ 10

Author(s):

ShivakumarM Channabasappa ◽

VijayaR Shetty ◽

ShruthiK Dharmappa ◽

Jahanabi Sarma

Keyword(s):

Cataract Surgery ◽

Local Anesthetics ◽

Efficacy And Safety ◽

Peribulbar Block

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Peribulbar anesthesia for strabismus surgery in adult patients

European Journal of Ophthalmology ◽

10.1177/1120672120974947 ◽

2020 ◽

pp. 112067212097494

Author(s):

Aldo Vagge ◽

Franco Simonetti ◽

Maria Marenco ◽

Carmen Burtolo ◽

Maria Musolino ◽

...

Keyword(s):

Visual Acuity ◽

Medical Records ◽

Strabismus Surgery ◽

Adult Patients ◽

Study Group ◽

Efficacy And Safety ◽

Oculocardiac Reflex ◽

Peribulbar Block ◽

Peribulbar Anesthesia ◽

Intravenous Atropine

Purpose: To evaluate the efficacy and safety of peribulbar anesthesia during strabismus surgery. Methods: Medical records of patients undergoing strabismus surgery and peribulbar anesthesia were reviewed. The overall efficacy of peribulbar anesthesia was evaluated as requirement of supplemental peribulbar anesthesia, impossibility to perform eye muscles surgery due to inadequate efficacy of the block and peribulbar block complications that occurred up to 6 weeks postoperatively. Presence of oculocardiac reflex (OCR) and presence of decreased visual acuity and afferent pupillary defect postoperatively were reported. Results: A total of 510 patients comprised our study group. The total amount of peribulbar injections was 717. Four patients (0.7%) required supplemental injection in the superonasal quadrant. Five of 510 (0.9%) required an anesthesiologic intervention with intravenous atropine. Eighty patients of 510 (15.6%) complained about transitory complete ptosis and/or amaurosis postoperatively. No complications were observed up to 6 weeks postoperatively. Conclusion: Peribulbar anesthesia was an effective and safe option during strabismus surgery in adult patients.

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Efficacy and Safety of Corneal Transplantation Using Corneas from Foreign Donors versus Domestic Donors: A Prospective, Randomized, Controlled Trial

Journal of Ophthalmology ◽

10.1155/2015/178289 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Yingxin Chen ◽

Congling Liao ◽

Minghong Gao ◽

Michael Wellington Belin ◽

Mingwu Wang ◽

...

Keyword(s):

Postoperative Complications ◽

Controlled Trial ◽

Corneal Transplantation ◽

Graft Infection ◽

Efficacy And Safety ◽

Significant Difference ◽

Domestic Group ◽

Corneal Endothelial Cell Density ◽

Donor Corneas ◽

Foreign Donor

Purpose. To assess the efficacy and safety of corneal transplantation using corneas from foreign donors.Methods. One hundred and eight patients needing therapeutic penetrating keratoplasty were randomly divided into 2 groups (54 cases/group): foreign group using foreign donor corneas and domestic group using domestic donor corneas. Clinical outcome and incidence of postoperative complications were compared between groups.Results. No significant difference with respect to the therapeutic outcome and postoperative Best Corrected Visual Acuity (BCVA) and neovascularization by final follow-up was observed between the two groups. The graft thickness in the foreign group was statistically higher than the domestic group at 1 month postoperatively, but not at 3, 6, and 12 months postoperatively. Corneal endothelial cell density in the domestic group was statistically higher than in the foreign group at 3, 6, and 12 months postoperatively. Corneal epithelial abnormalities in the foreign group were significantly higher than that in domestic group. The primary graft failure, incidence of graft survival, and postoperative complications such as immunologic rejection, graft infection, and secondary glaucoma were not significantly different between the two groups.Conclusions. Corneal transplantations using foreign donor corneas are as effective and safe as those using domestic donor corneas.

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Photorefractive Keratectomy in Keratoconus

Case Reports in Ophthalmology ◽

10.1159/000431306 ◽

2015 ◽

Vol 6 (2) ◽

pp. 260-268 ◽

Cited By ~ 7

Author(s):

Deepali Sandeep Tambe ◽

Anders Ivarsen ◽

Jesper Hjortdal

Keyword(s):

Corneal Transplantation ◽

Photorefractive Keratectomy ◽

Efficacy And Safety ◽

Corrected Distance Visual Acuity ◽

Risk Of Progression ◽

Long Term Follow Up ◽

The Mean ◽

Subsequent Risk

Purpose: To assess the efficacy and safety of topography-guided photorefractive keratectomy (PRK) for keratoconus and to estimate the subsequent risk of progression. Methods: This is a retrospective follow-up study. Between 1998 and 2013, 28 eyes of 23 patients (age 17-60) with grade 1-3 keratoconus received topography-guided PRK. Corrected-distance visual acuity (CDVA), keratometry, pachymetry, and corneal topography were assessed before, after 3 months, and at a late follow-up of a median of 7 years after the procedure. Postoperative complications including subsequent keratoplasty were noted. Results: Of the 28 eyes, 5 (18%) had undergone corneal transplantation at a median of 7 years (range 3-10) after PRK. Four eyes were not available for follow-up. In the remaining 19 eyes, CDVA was improved in 16 eyes (84.3%), reduced in 2 eyes (10.5%), and unchanged in 1 eye (5.2%). Thus, average CDVA had improved from 0.49 logMAR before PRK to 0.27 logMAR at 3 months, and to 0.24 at the long-term follow-up. The mean spherical equivalent was reduced from -6.2 to -3.7 dpt after 3 months and to -2.1 dpt at the late follow-up. Similarly, the mean cylinder was reduced from -4.2 to -3.0 dpt after 3 months and at the late follow-up. Conclusion: Topography-guided PRK in keratoconus may be effective for reducing myopia and astigmatism and may offer a temporary or permanent alternative to keratoplasty in contact lens-intolerant keratoconus. In the present study, we found a low risk of keratoconus progression after PRK.

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