Severe adverse events associated with local anaesthesia in cataract surgery: 1 year national survey of practice and complications in the UK

Lee, Richard M. H.; Thompson, John R.; Eke, Tom

doi:10.1136/bjophthalmol-2015-307060

Cited by 49 publications

(53 citation statements)

References 17 publications

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“…We aimed to collect data prospectively across Australia and New Zealand (NZ) via the Australian and New Zealand Ophthalmic Surveillance Unit. This would provide information on the usage of each technique and an incidence of the various adverse events in a similar fashion to studies of the British Ophthalmic Surveillance Unit …”

Section: Anaesthetic Techniques Usedsupporting

confidence: 62%

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Surveillance of adverse events associated with local anaesthesia for cataract surgery in Australia and New Zealand

Clarke

Mills

2016

Clinical Exper Ophthalmology

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Section: Anaesthetic Techniques Usedsupporting

confidence: 62%

“…It was a 25‐month prospective observational study between June 2012 and June 2014 of cataract surgery in Australia and NZ with regard to severe complications of local anaesthesia. The method of data collection is well described in previous research …”

Section: Anaesthetic Techniques Usedmentioning

confidence: 99%

Surveillance of adverse events associated with local anaesthesia for cataract surgery in Australia and New Zealand

Clarke

Mills

2016

Clinical Exper Ophthalmology

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“…Topical‐intracameral anaesthesia (TIA) is a safe and well‐tolerated method for anaesthetizing the eye during routine phaco‐emulsification cataract surgery. Over the past decade, there has been a trend towards lower utilization of sharp needle blocks (retrobulbar and peribulbar anaesthesia) and increasing use of subTenon blocks, TIA and topical anaesthesia . Use of TIA eliminates the risks of eye blocks, which include globe perforation (2.23 per 10 000 cases), periorbital haemorrhage (2.9 per 10 000 cases) and central retinal artery occlusion (0.7 per 10 000 cases) .…”

mentioning

confidence: 99%

“…Over the past decade, there has been a trend towards lower utilization of sharp needle blocks (retrobulbar and peribulbar anaesthesia) and increasing use of subTenon blocks, TIA and topical anaesthesia . Use of TIA eliminates the risks of eye blocks, which include globe perforation (2.23 per 10 000 cases), periorbital haemorrhage (2.9 per 10 000 cases) and central retinal artery occlusion (0.7 per 10 000 cases) . The recently described paracentral acute middle maculopathy has not been observed after TIA .…”

mentioning

confidence: 99%

Survey on anaesthesia used for phaco‐emulsification cataract surgery: A needs analysis for teaching topical‐intracameral anaesthesia to ophthalmology trainees

Lee

Cleary

Webster

2019

Clinical Exper Ophthalmology

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“…Local anaesthesia in cataract surgery severe corneal oedema were reported in all techniques of local aneathesia except topical-intracameral and subconjunctival local anaesthesia [56] . The increasing order of quality scores (central eye position, anesthesia, akinesia of the eye and or body, soft tissue or orbital hemorrhage, and absence of vitreous bulge) were in subTenon's, peribulbar, retrobulbar and finally general anaesthesia [57] .…”

mentioning

confidence: 99%

Local Anaesthesia in Cataract Surgery

Reddy

Thevi

2017

International Journal of Ophthalmic Research

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nerves of the cornea and the conjunctiva (long and short ciliary nerves, nasociliary nerves). This technique eliminates the possible complications of injectable anesthesia. However, it does not eliminate pain sensitivity of the iris, the zonule, and the ciliary body which is achieved by intracameral technique of anesthesia with preservative free 1% lidocaine. In a constantly evolving arena, the sub-Tenon's block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but there is a possibility of getting an allergic reaction. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. INTRODUCTIONThe ideal anaesthesia would be one that provides adequate pain relief during surgery and postoepratively, be easy to administer and have minimal complications. For doing cataract surgery, the anaesthesia could be local or general. Majority of cataract patients are operated under local anaesthesia (infiltration, topical, intracameral). The infiltration anaesthesia is given as retrobulbar or peribulbar or subTenon's block. Carl Koller first used cocaine as a topical anaesthetic for eye surgery in 1884 [1] . The general anaesthesia has its own complications in elderly cataract patients and most of them may have diabetes or hypertension or heart diseases or combination of them. No need of fasting before or after surgery, no need of intubation, no need of using any systemic medications are the advantages of local anaesthesia. However, cataract in children, patients with parkinsonism, deaf mute patients, mental retardation patients, patients ABSTRACTThere has been a significant evolution in surgical technique of cataract extraction. The technical advances in phaco machines, phacotips, and availability of ophthalmic viscoelastic devices have played a great role in cataract surgery to be faster and more controlled now than before. Similarly, local anesthesia techniques in cataract surgery have also advanced significantly from retrobulbar, peribulbar, sub-Tenon's, to topical anaesthesia. Even though, the sub-Tenon's anesthesia technique reduced the risk of complications of peribulbar/ retrobulbar anesthesia but the technique is still associated with a possibility of damage to optic nerve, retrobulbar hemorrhage, and ocular muscle injury. Topical anesthesia is used to block the afferent EDITORIAL

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Severe adverse events associated with local anaesthesia in cataract surgery: 1 year national survey of practice and complications in the UK

Abstract: Background: Recent years have seen a major change in practice of local anaesthesia (LA) for cataract surgery.

Cited by 49 publications

References 17 publications

Surveillance of adverse events associated with local anaesthesia for cataract surgery in Australia and New Zealand

Surveillance of adverse events associated with local anaesthesia for cataract surgery in Australia and New Zealand

Survey on anaesthesia used for phaco‐emulsification cataract surgery: A needs analysis for teaching topical‐intracameral anaesthesia to ophthalmology trainees

Local Anaesthesia in Cataract Surgery

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