Subkonjunktivalanästhesie oder Vollnarkose bei der Trabekulektomie - retrospektive Analyse des perioperativen Blutungsrisikos aus Sicht des Glaukomchirurgen

Ts, Dietlein; Moalem, Y.; Am, Schild; Lappas, Alexandra; Rosentreter, André; Dinslage, Sven

doi:10.1055/s-0031-1299493

Cited by 4 publications

(2 citation statements)

References 5 publications

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“… 53 However, this study only had a small number of cases that used subconjunctival LA, and this finding has not been replicated. Other studies have found no difference in outcome, when comparing subconjunctival LA and Ga 54 55 and subconjunctival vs Topical, 58 or subconjuctival vs retrobulbar (non-penetrating surgery). 56 A recent review article on ‘modern filtration surgery’ concluded that ‘subconjunctival anesthesia is safe’.…”

Section: Preoperative Preparation: Does the Patient Really Need A Tramentioning

confidence: 92%

Preoperative Preparation and Anesthesia for Trabeculectomy

Eke

2016

Journal of Current Glaucoma Practice

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Preoperative preparation should improve the likelihood of successful trabeculectomy surgery. The team can reconsider the appropriateness of the proposed surgery, and steps can be taken to maximize the chance of a good outcome. For example, adjustments to anti-hypertensive or anti-coagulant medications may be made, and topical ocular medications adjusted.Choice of anesthesia technique is of particular relevance to the trabeculectomy patient. Some anesthesia techniques are more likely to have serious complications, and glaucoma patients may be at higher risk of some sight-threatening complications, because the optic nerve is already damaged and vulnerable. Posterior placement of local anesthesia (retrobulbar, peribulbar, posterior sub-Tenon’s techniques) could potentially damage the optic nerve, and thereby cause “wipe-out” of vision. Anesthesia technique may influence the likelihood of vitreous bulge and surgical difficulty. Regarding long-term control of intraocular pressure, there is no good evidence to indicate that any particular anesthesia technique is better than another. There is little high-quality evidence on this topic. The author’s preferred technique for trabeculectomy is subconjunctival-intracameral anesthesia without sedation.How to cite this article: Eke T. Preoperative Preparation and Anesthesia for Trabeculectomy. J Curr Glaucoma Pract 2016; 10(1):21-35.

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Section: Preoperative Preparation: Does the Patient Really Need A Tramentioning

confidence: 92%

Preoperative Preparation and Anesthesia for Trabeculectomy

Eke

2016

Journal of Current Glaucoma Practice

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“…älter zeigt die statistische Auswertung keine Zunahme der Komplikationen mit dem Alter. Ähnlich wie in unserer früheren Studie [13] bei Patienten mit einem mittleren Alter von 65 Jahren (l " Tab. 5) zeigt sich in dieser Studie bei einem mittleren Alter von 84 Jahren auch kein erkennbar erhöhtes postoperatives Risikoprofil, unabhängig davon, ob [20].…”

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Antiglaukomatöse Filtrationschirurgie bei alten Glaukompatienten ab dem 80. Lebensjahr: Analyse der postoperativen Risiken

Dietlein

Moalem

Lappas

et al. 2014

Klin Monatsbl Augenheilkd

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Moderne Filtrationschirurgie

Klink

Grehn

2013

Ophthalmologe

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Preoperative treatment with steroids and nonsteroidal anti-inflammatory drugs increases the success of filtration surgery. Surgery with the patient under subconjunctival anesthesia is safe. Intraoperative application of mitomycin C is state of the art and enhances success rates. Perioperative use of bevacizumab seems to attenuate postoperative fibrosis. Postoperative hypotension is avoided by stable fixation of the scleral flap followed by stepwise controlled suturelysis or release. Transconjunctival flap suturing allows fast and simple treatment of overfiltration. The shorter the time lag between trabeculectomy and subsequent cataract surgery the higher the probability of bleb failure will be. The number of antiglaucomatous drugs and severity of glaucomatous damage before surgery correlate with the probability of failure and blindness.

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Subkonjunktivalanästhesie oder Vollnarkose bei der Trabekulektomie - retrospektive Analyse des perioperativen Blutungsrisikos aus Sicht des Glaukomchirurgen

Cited by 4 publications

References 5 publications

Preoperative Preparation and Anesthesia for Trabeculectomy

Preoperative Preparation and Anesthesia for Trabeculectomy

Antiglaukomatöse Filtrationschirurgie bei alten Glaukompatienten ab dem 80. Lebensjahr: Analyse der postoperativen Risiken

Moderne Filtrationschirurgie

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