A two-year prospective study comparing lidocaine 2% jelly versus peribulbar anaesthesia for 25G and 23G sutureless vitrectomy

Abstract

Lidocaine 2% jelly with or without peroral preoperative morphine and dixyrazine offers adequate analgesia to perform sutureless vitrectomy. Lack of akinesia does not prevent a successful surgical result.

Intraocular Gas Dynamics After 20-Gauge and 23-Gauge Vitrectomy With Sulfur Hexafluoride Gas Tamponade

“…Compared with the flexible 25-gauge instruments, the stiffer and larger 23-gauge instruments allow for ocular movements to be more easily controlled and manipulations during surgery are more secure and unrestricted. 3,4 Thus, although the 25-gauge instruments are constantly improved, some vitreoretinal surgeons may prefer to perform 23-gauge TSV for complicated vitreoretinal surgery that requires thorough removal of peripheral vitreous gel and long-acting gas tamponade.Transconjunctival sutureless vitrectomy with gas tamponade requires more complete closure of sclerotomy sites because dysfunction in self-sealing could cause an early postoperative gas leakage, thus leading to decreased tamponade efficiency. It is true that postoperative intraocular pressure (IOP) is a good index of wound closure in fluid-filled eyes, but postoperative gas volume and its decreasing process would also be important indices in gas-filled eyes.…”

Vitrectomía y facovitrectomía con anestesia tópica/intracameral

“…En las series comparativas de anestesia tópica versus bloqueo peribulbar/retrobulbar se ha descrito que no existe una diferencia estadísticamente significativa en percepción del dolor por el paciente, siendo esta ≤ grado 1 en el 80% de los casos, similar a lo encontrado en este estudio, por lo que la anestesia tópica puede ser considerada como una alternativa a otros procedimientos anestésicos en vitrectomía 23 y 25 g 30,32 . Bahçecioglu et al 33 recomiendan el uso de sedación en combinación con anestesia tópica para procedimientos de segmento posterior, aunque no hay estudios comparativos en cirugía vitreorretiniana bajo anestesia tópica con o sin sedación.…”

Safety, efficacy, and patient acceptability of lidocaine hydrochloride ophthalmic gel as a topical ocular anesthetic for use in ophthalmic procedures

“…20 There were 2 papers on lidocaine gel for intravitreal injection, 21,22 and 1 on vitrectomy. 23 In addition there was 1 paper each on lidocaine gel in the setting of penetrating keratoplasty, 24 strabismus surgery, 25 and chalazion excision. 26 randomized controlled trials (rCT) Salient points from the 15 7,27 the remaining 13 were unblinded but considered to be high-quality with the exception of 2 that were possibly underpowered (N  20).…”