Intraocular Anesthesia

Gills, Jr Jp; Johnson, D.H.; Cherchio, Myra; Raanan, Marsha G.

doi:10.1016/s0896-1549(05)70026-2

Cited by 6 publications

(5 citation statements)

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“…(5) Intracameral Injected though corneal incision during surgeryPreservative-free anesthetic agent (usually lidocaine 1%) is injected into the anterior chamber at the beginning of the operation through 1 of the corneal incisions required for phacoemulsification. It provides sensory blockage of the axis and the ciliary body (from Cass26 and Gills et al68 ).…”

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confidence: 99%

Local anesthesia for cataract surgery

Malik¹,

Fletcher²,

Chong³

et al. 2010

Journal of Cataract and Refractive Surgery

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Various aspects of local anesthesia for cataract surgery, such as the anesthetic agents and their interaction with ocular nerve supply, anesthesia requirements, available clinical techniques and their inherent complications are reviewed. A comparative evaluation of clinical techniques in terms of efficacy, akinesia, and patient-perceived pain during both anesthesia administration and intraoperative cataract surgery is presented, along with the prevailing practice patterns of anesthesia techniques among refractive surgeons in the United Kingdom and United States. More randomized clinical trials are needed to facilitate statistical methods of metaanalysis to establish convincingly the overall benefits and efficacy of the various local anesthesia procedures in cataract surgery. The wide scope of the present review is of relevance in structuring ophthalmology and anesthesia specialist training programs for junior staff.

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mentioning

confidence: 99%

Local anesthesia for cataract surgery

Malik¹,

Fletcher²,

Chong³

et al. 2010

Journal of Cataract and Refractive Surgery

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“…[7,9] However, safer and newer drugs are being investigated in ocular anesthesia to improve surgical techniques. In particular, ropivacaine may represent a safer alternative to lidocaine, thanks to its long-term efficacy and modest vasoconstrictive action, which is usually an advantageous side effect in anterior segment surgery.…”

Section: Resultsmentioning

confidence: 99%

“…This was easily evaluated by specular microscopy and electronic scansion microscopy. [8] Gills et al[9] have reported a transient loss of vision in 4 cases in a total of over 15 000 patients. This was essentially due do a dialysis of the posterior capsule with lidocaine interfering with ganglion cell function.…”

Section: Introductionmentioning

confidence: 99%

Cataract Surgery Complications

et al. 2011

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Background: Intraoperative lidocaine is widely used in controlling discomfort during cataract surgery. However, recent studies have confirmed the toxic effect of lidocaine on ganglion cells. Ropivacaine is an anesthetic recently introduced in clinical practice that couples a long anesthetic effect with a mild vasoconstrictive action.Objective: The aim of this study was an in vitro evaluation of the efficacy of ropivacaine in reducing the degenerative effects usually observed during lidocaine treatment.Methods: Ropivacaine and lidocaine toxicity has been evaluated in murine fibroblasts 3T6 by measuring percentage of cell death, cell growth inhibition, and DNA degradation. The choice of this cellular line is motivated by the presence of a complete apoptotic system that can be assimilated to the endothelium precursor cells.Results: We observed that lidocaine 0.25% decreases cell viability and causes DNA degradation in murine fibroblasts 3T6, whereas ropivacaine 0.5% does not cause any cellular or molecular degenerative effect.Conclusions: Our in vitro studies confirm that ropivacaine is less toxic than lidocaine to these cells. Therefore, in vivo studies in the anterior chamber could be useful to evaluate the effects of ropivacaine versus lidocaine in intracameral anesthesia in cataract surgery.

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“…Preservative free anaesthetic (usually 1% lidocaine) is injected into the anterior chamber at the beginning of the operation through one of the corneal incisions required for phacoemulsification. It provides sensory blockage of the axis and the ciliary body (For detailed procedural techniques see Refs [38,110]) Table 5: Various regional anaesthetic injection approaches and the resulting lockade of relevant nerves.…”

Section: Topical Anesthesiamentioning

confidence: 99%