I. P. Theocharis, Z. Tomic, A. Alexandridou, N. J. Gilli

Purpose:

To evaluate the safety and patients’ tolerance to topical anaesthesia in vitreoretinal surgery in selected cases, including combined phaco-vitrectomy procedures, macula surgery and cases of complicated cataract surgery as well.

Methods:

Twelve (12) patients were operated with 25g vitrectomy under topical anaesthesia with 2% unpreserved xylocaine gel for various vitreoretinal diseases, including epimacular membrane (n=3), diabetic macular edema with triamcinolone injection (n=2), macula hole (n=3) removal of heavy liquid bubbles (n=1), retinal detachment with vitreous haemorrhage (n=1), dislocated crystalline lens after complicated cataract operation (n=2). Patients’ pain and the surgeon’s evaluation about the difficulty of the operations were recorded.

Results:

In one patient the operation was converted to conventional 20g surgery and subtennon anaesthesia because of bleeding from the sclerotomy sites at the end of the procedure. No other patient required peribulbar anaesthesia. Anaesthesiologists were not present at any time during the procedures. One patient experienced mild incidental pain during prolapsed-iris manipulation, one patient with ocular inflammation during scleral indentation and all patients during the injection of subconjunctival steroids and antibiotics at the end of the operation. No patient had pain postoperatively. No anaesthesia-related complication was noted during surgery or at the first postoperative examination the day after. Macula surgery seems to be much more difficult with topical anaesthesia comparing with peribulbar injection of anaesthetics.

Conclusion:

25g vitrectomy can be safely performed with topical anaesthesia in selected cases. An additional advantage to sutureless vitrectomy.