15
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Feasibility and safety of vitrectomy under topical anesthesia in an office-based setting

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Purpose:

          The purpose of this study was to evaluate the feasibility and safety of office-based vitreoretinal procedures.

          Methods:

          Patients undergoing primary elective pars plana vitrectomy were elected for surgery in an office-based setting (performed in a minor procedure room under topical anesthesia [TA] and oral anxiolysis). Rates of surgical objective achievement, surgical timing, and comfort were recorded to evaluate feasibility. Intraoperative and postoperative adverse events were assessed to evaluate safety.

          Results:

          Office-based vitrectomy surgery was performed in 34 eyes of 30 patients. The mean surgical time was 12.351 ± 8.21 min. Surgical objectives were achieved in 100% of cases. The mean best-corrected visual acuity improvement was 9.08 letters ( P < 0.0001). During most parts of the procedure, no patient reported pain or discomfort. Neither intraoperative nor postoperative adverse events were reported until the final follow-up visit.

          Conclusion:

          Office-based vitreoretinal procedures under TA could be as feasible and as safe as vitreoretinal procedures under conventional anesthesia.

          Related collections

          Most cited references23

          • Record: found
          • Abstract: found
          • Article: not found

          Ocular complications associated with retrobulbar injections.

          The authors describe six complications, of retrobulbar injections documented by fundus photography and fluorescein angiography. These include (1) injection of corticosteroid into the posterior ciliary arterial circulation resulting in emboli in the vasculature of the choroid and the optic nerve head; (2) injection of corticosteroid into the ophthalmic artery resulting in emboli in both the choroidal and retinal circulations; (3) presumed injection of lidocaine and air into the optic nerve sheath adjacent to the globe with extension anteriorly into the subretinal space and the space between the posterior vitreous and the internal limiting membrane; (4) occlusion of the central retinal artery without an associated retrobulbar hemorrhage; (5) trauma to and partial injection of lidocaine in the central retinal artery with embolization into the retinal circulation; and (6) presumed injection of lidocaine into the optic nerve sheath producing a combined central retinal vein and artery occlusion. Alternative techniques that might decrease the incidence of complications associated with retrobulbar injections are discussed.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Globe perforation associated with subtenon's anesthesia.

            To report a case of globe perforation while initiating posterior subtenon's anesthesia. Case report. A 40-year-old man with a history of retinal detachment in both eyes presented for repair of a second retinal detachment in the LE. Upon dissecting a space beneath the Tenon capsule with scissors, the globe was perforated. In patients with prior ophthalmologic surgery, thinned sclera, or excess scar tissue, increased caution should be employed during initiation of sub-Tenon anesthesia or an alternative method should be used.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Needle penetration of the globe during retrobulbar and peribulbar injections.

              The charts of 23 patients with needle penetration of the globe during retrobulbar or peribulbar injections between January 1980 and May 1990 were reviewed. Possible needle penetration risk factors included high myopia, previous scleral buckling procedures, injection by nonophthalmologists, and poor patient cooperation during the injection. Of the 23 cases of ocular penetration, 16 (70%) were from sharp (22-, 23-, and 25-gauge) needles, and 7 (30%) were from blunt (23- and 25-gauge) needles. Management options depended on the severity of the intraocular injury. Retinal breaks without retinal detachment were treated by laser photocoagulation (four cases) or cryopexy (one case) and were observed in three cases. More advanced complications (retinal detachment and vitreous hemorrhage) were usually treated by pars plana vitrectomy with or without a scleral buckle (12 of 14 cases). The final visual acuity was 20/400 or better in only 2 of the 14 retinal detachment cases. In cases without retinal detachment, the final visual acuity was 20/50 or better in 7 of 9 cases.
                Bookmark

                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0301-4738
                1998-3689
                August 2018
                : 66
                : 8
                : 1136-1140
                Affiliations
                [1 ]Centro De Retina Médica Y Quirúrgica, S.C., Centro Médico Puerta De Hierro, Zapopan, Jalisco, México
                [2 ]Tecnologico De Monterrey, Escuela De Medicina Y Ciencias De La Salud, Zapopan, Jalisco, México
                Author notes
                Correspondence to: Dr. Arturo Santos, Centro De Retina Médica Y Quirúrgica, S.C. Boulevard Puerta De Hierro 5150-202 A, Puerta De Hierro, 44160 Zapopan, Jalisco, México. E-mail: asantos@ 123456e-retina.com
                Article
                IJO-66-1136
                10.4103/ijo.IJO_289_18
                6080475
                30038158
                2ea14cb1-0ad7-4b6d-8fba-0fd91fda3ebf
                Copyright: © 2018 Indian Journal of Ophthalmology

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 07 March 2018
                : 26 April 2018
                Categories
                Original Article

                Ophthalmology & Optometry
                office-based,topical anesthesia,vitrectomy,vitreoretinal procedures
                Ophthalmology & Optometry
                office-based, topical anesthesia, vitrectomy, vitreoretinal procedures

                Comments

                Comment on this article