Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases

Lam, Dennis S.C.; Leung, Hiu Ying; Liu, Shu; Radke, Nishant; Yuan, Ye; Lee, Vincent Y. W.

doi:10.22608/apo.201735

Cited by 9 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although there are reports of topical anesthesia for vitrectomy, their use is limited to symptomatic floaters, and using 27 G instruments. 19 , 20 So far, local anesthesia is still an alternative and a safe procedure compared to general anesthesia, as also shown in other studies. 21…”

Section: Discussionmentioning

confidence: 66%

Cost analysis of vitrectomy under local versus general anesthesia in a developing country

Simanjuntak

Djatikusumo²,

Adisasmita³

et al. 2018

OPTH

View full text Add to dashboard Cite

PurposeTo report cost reductions of vitrectomy under local anesthesia.Patients and methodsThis was a retrospective cohort study using medical records of consecutive patients undergoing vitrectomy surgery for retinal detachment under general or local anesthesia. Data of patient’s fulfilling the inclusion criteria were included in the study. The patients were divided into two groups: Group 1 (local anesthesia) and Group 2 (general anesthesia). The preoperative data were checked and validated by a peer group consisting of two ophthalmologists, two internists, and two anesthesiologists independently in a blind manner. The calculation of the cost was done using the cost minimization analysis. The cost data were obtained from the finance division of the hospital for each individual treatment. The cost data included unit cost of laboratory tests, surgery, and medications.ResultThere were 100 subjects (50 subjects in each group) assessed by peer groups and declared eligible to undergo surgery under either local or general anesthesia. Both groups were equal. The total average cost for vitreous surgery under general anesthesia for each patient was $322.17, whereas for local anesthesia it was $220.57. The mean difference was $101.60 (46.06%) saving on local anesthesia.ConclusionVitrectomy surgery under local anesthesia can reduce the cost by almost half that of general anesthesia. The present study showed that the type of anesthesia determined the ultimate cost for the surgery. Hence, surgery under local anesthesia appears affordable and cost-effective, especially in a developing country like Indonesia.

show abstract

Section: Discussionmentioning

confidence: 66%

Cost analysis of vitrectomy under local versus general anesthesia in a developing country

Simanjuntak

Djatikusumo²,

Adisasmita³

et al. 2018

OPTH

View full text Add to dashboard Cite

show abstract

“…9 Recent studies have shown that local anesthetics that include lignocaine , amethocaine and bupivacaine are effective in providing topical and local anesthesia for intraocular surgery and Instillation of these local anesthesia decreases intraocular pressure (IOP) transiently . 12,8,5,13 As the duration of anesthesia and analgesia is very brief by these drugs , it requires repeat instillation of drops in the conjuctival sac after every 30 minutes but long-term use of these topical drugs is associated with ocular surface toxicity as they contain preservatives like benzalkonium chloride Most of the patients were in their fifth and sixth decade of life when they underwent 23 gauge three port pars removal of sillicone oil. The peribulbar technique for local anesthesia is a type of block that has been introduced and developed as ocular and periocular anesthetic technique for surgical procedures recently.…”

Section: Discussionmentioning

confidence: 99%

“…4 Apart from vitreo retinal procedures , topical anesthesia is also used in routine phacoemulsification procedures and ocular surgeries like trabeculectomy and pterygium excision . 5 Conventional 20-guage, 23-guage, and 25-guage sutureless pars plana vitrectomies have been performed under topical anesthesia in view of their early visual rehabilitation and good analgesic effect for the procedure. Mahajan et al have studied the effect of topical versus peribulbar anesthesia for patients undergoing pars plana vitrectomy for vitreous hemorrhage and found that the pain score between the two groups was almost similar with the only difference that in topical anesthesia group the maximum pain during the procedure is felt at the time of trocar insertion whereas in the peribulbar block it is felt at the time of local anesthesia being given but the topical anesthesia does not cause lie edema and conjuctival chemosis that is seen in routine patients with peribulbar anesthesia.…”

Section: Introductionmentioning

confidence: 99%

Topical Vs Pribulbar Anesthesia in Patients Undergoing 23 Guage ,Three Ports Removal of Sillicone Oil

Shahid¹,

Rashid²,

Tauqeer³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Objective: To compare safety as well as efficacy of topical anesthesia against peribulbar anesthesia for patients undergoing three ports pars plana removal of silicone oil . Background: Silicone oil is used as a temponarding agent for vitreoretinal procedures and have to be removed according to the duration of temponard required as it is associated with complications like development and acceleration of cataract devlopment , secondary open angle glaucoma and corneal decompensation. It can be removed via three port 23 gauge ROSO procedure both under topical and peribulbar anesthesia. Patients & Methods: 40 eyes from 40 patients who underwent three port ROSO with a 23 gauge port system were randomised into two groups of 20 patients each for this study. In group A eyes was operated under topical anesthesia using soaked cotton wisk with 0.5 % proparacaine hydrochloride , placed for five minutes in superior and inferior fornix before the start of surgery and the group B was operated under peri bulbar block with 4 ml of bupivacaine given five minutes before the start of surgical procedure. Pain scoring charts were used by patients to rate their pain after the procedure. Results: The patients in this study had a mean age of 58.46 ±3.62 years, with a range of 30-65 years. 40 individuals were treated, with 26 being male and 14 being female. The mean pain score for patients in topical anesthesia group was 3.8+- 0.5 and the mean pain score in peribulbar block group was 2.2+-0.2 with a p value of 0.01. Conclusion: Peribulbar block is superior to topical anesthesia in patient comport for patients undergoing three port ROSO procedures. Keywords: ROSO, Silicone oil, peribulbar, Topical anesthesia, Bupicaine, Proparacaine hydrochloride.

show abstract

“…There was no obvious explanation to their visual symptoms. Floaterectomy may help in the second patient but it carries certain risks [ 12 ]. Agarwal et al [ 11 ] believed the pinhole accentuates even small-medium vitreous opacities and creates such visual disturbance.…”

Section: Discussionmentioning

confidence: 99%

One-year visual outcome of secondary piggyback pinhole device implantation in pseudophakic eyes with irregular corneal astigmatism and iris trauma

El‐Alfy

Hamada

et al. 2021

Eye

View full text Add to dashboard Cite

Purpose Retrospective case series evaluating the efficacy and safety of implanting XtraFocus ™ pinhole device in pseudophakic patients with irregular corneal astigmatism with concurrent or standalone iris defect. Methods Electronic case records were searched for: uncorrected distance visual acuities (UDVA) and corrected distance visual acuities (CDVA), automatic or manifest refraction and spherical equivalent (SE). All main outcomes were evaluated preoperatively and postoperatively at 1, 3, 6, 9 and 12 months, along with patients’ satisfactory outcome and complications. Results Eleven pseudophakic eyes of 11 patients with a mean age of 54 (range 27–81) years were included. Median UDVA improved significantly from logMAR 0.7 (range 0.1–1.22) pre-operatively to 0.4 (range 0–1.3) at 1-month ( p = 0.002); median CDVA remained unchanged at logMAR 0.4 (range 0–0.1) pre-operatively and 0.4 (range 0–0.8) at 1-month ( p = 0.36). There were no significant statistical differences in both UDVA and CDVA between the post-operative periods. Ten patients (90.9%) had initial UDVA improvement at 1-month post op. Eight (72.7%) patients expressed satisfaction with improved vision or reduction of glare/halos. Three (27.3%) patients had unsatisfactory visual outcome resulting in 2 requested for implant explantation due to worsening of glare and distressing floaters. Conclusions XtraFocus ™ is effective in improving vision or reducing glare in pseudophakic patients with irregular corneal astigmatism or intragenic iris trauma, with over 70% expressed satisfactory outcome. Disturbing floaters and glare preclude its use in some resulting in implant explantation.

show abstract

Two-Port Pars Plana Anterior and Central Core Vitrectomy (Lam Floaterectomy) in Combination With Phacoemulsification and Intraocular Lens Implantation Under Topical Anesthesia for Patients with Cataract and Significant Floaters: Results of the First 50 Consecutive Cases

Abstract: The 3-month results in terms of safety and efficacy of the Lam floaterectomy in combination with phaco and IOLfor patients with cataract and significant floaters under topical anesthesia are encouraging. Further larger-scale, prospective, multicenter studies seem warranted.

Cited by 9 publications

References 0 publications

Cost analysis of vitrectomy under local versus general anesthesia in a developing country

Cost analysis of vitrectomy under local versus general anesthesia in a developing country

Topical Vs Pribulbar Anesthesia in Patients Undergoing 23 Guage ,Three Ports Removal of Sillicone Oil

One-year visual outcome of secondary piggyback pinhole device implantation in pseudophakic eyes with irregular corneal astigmatism and iris trauma

Contact Info

Product

Resources

About