Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures
Dagobert Lerch, 1, 2 Jan A Venter, 2 Anca M James, 1, 2 Martina Pelouskova, 2 Barrie M Collins, 2 Steven C Schallhorn 2–4 1Montanamed Ltd., Sankt Gallen, Switzerland; 2Optical Express, Glasgow, UK; 3University of California, Department of Ophthalmology, San Francisco, CA, USA; 4Carl Ze...
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Dove Medical Press
2020
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oai:doaj.org-article:73bdfc4635154ca495ad5ccc2370665b2021-12-02T03:42:09ZOutcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures1177-5483https://doaj.org/article/73bdfc4635154ca495ad5ccc2370665b2020-01-01T00:00:00Zhttps://www.dovepress.com/outcomes-and-adverse-events-of-sub-tenons-anesthesia-with-the-use-of-a-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Dagobert Lerch, 1, 2 Jan A Venter, 2 Anca M James, 1, 2 Martina Pelouskova, 2 Barrie M Collins, 2 Steven C Schallhorn 2–4 1Montanamed Ltd., Sankt Gallen, Switzerland; 2Optical Express, Glasgow, UK; 3University of California, Department of Ophthalmology, San Francisco, CA, USA; 4Carl Zeiss Meditec, Dublin, CA, USACorrespondence: Dagobert LerchMontanamed Ltd, Ozartstraße 6, Leipzig D-04107, GermanyTel +49 152 53447537Email info@montanamed.chPurpose: To describe our technique of sub-Tenon’s anesthesia and report adverse events and patient comfort.Setting: Optical Express, United Kingdom.Design: Retrospective case series.Methods: The outcomes of 35,850 intraocular procedures (phacoemulsification and implantation of an intraocular lens) were retrospectively reviewed and the incidence of adverse events related to sub-Tenon’s anesthesia was calculated. On the first postoperative day, patients were asked to complete a questionnaire enquiring about their comfort during and after the procedure. The anesthetic solution consisted of a combination of Lidocaine and Hyaluronidase, which was administered into sub-Tenon’s space with a single-use sterile polyurethane 22G x 1” (0.9 x 25 mm) cannula. Mild conscious sedation (midazolam) was used during anesthetic and surgical procedure.Results: No significant adverse events that would affect the posterior segment of the eye or result in vision loss were recorded. Subconjunctival haemorrhage related to sub-Tenon’s anesthesia was noted in 4.3% of eyes. Five minutes after the administration of sub-Tenon’s block, 80.6% of eyes had no chemosis, 14.8% had chemosis that affected only 1 quadrant of the eye and 4.5% of eyes had chemosis affecting 2 or more quadrants of the eye. Other adverse events included 14 cases of cyst/granuloma formation in the area of sub-Tenon’s incision and 7 eyes required suturing of the conjunctival cut. Of all patients, 93.2% experienced no or only mild discomfort during or after surgical procedure.Conclusion: Sub-Tenon’s anesthesia with the use of a flexible cannula is a safe option for ophthalmic anesthesia. No sight-threatening adverse events occurred.Keywords: sub-Tenon’s anesthesia, flexible cannula, refractive lens exchange, adverse eventsLerch DVenter JAJames AMPelouskova MCollins BMSchallhorn SCDove Medical Pressarticlesub-tenon’s anesthesiaflexible cannularefractive lens exchangeadverse eventsOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 307-315 (2020) |
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sub-tenon’s anesthesia flexible cannula refractive lens exchange adverse events Ophthalmology RE1-994 |
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sub-tenon’s anesthesia flexible cannula refractive lens exchange adverse events Ophthalmology RE1-994 Lerch D Venter JA James AM Pelouskova M Collins BM Schallhorn SC Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| description |
Dagobert Lerch, 1, 2 Jan A Venter, 2 Anca M James, 1, 2 Martina Pelouskova, 2 Barrie M Collins, 2 Steven C Schallhorn 2–4 1Montanamed Ltd., Sankt Gallen, Switzerland; 2Optical Express, Glasgow, UK; 3University of California, Department of Ophthalmology, San Francisco, CA, USA; 4Carl Zeiss Meditec, Dublin, CA, USACorrespondence: Dagobert LerchMontanamed Ltd, Ozartstraße 6, Leipzig D-04107, GermanyTel +49 152 53447537Email info@montanamed.chPurpose: To describe our technique of sub-Tenon’s anesthesia and report adverse events and patient comfort.Setting: Optical Express, United Kingdom.Design: Retrospective case series.Methods: The outcomes of 35,850 intraocular procedures (phacoemulsification and implantation of an intraocular lens) were retrospectively reviewed and the incidence of adverse events related to sub-Tenon’s anesthesia was calculated. On the first postoperative day, patients were asked to complete a questionnaire enquiring about their comfort during and after the procedure. The anesthetic solution consisted of a combination of Lidocaine and Hyaluronidase, which was administered into sub-Tenon’s space with a single-use sterile polyurethane 22G x 1” (0.9 x 25 mm) cannula. Mild conscious sedation (midazolam) was used during anesthetic and surgical procedure.Results: No significant adverse events that would affect the posterior segment of the eye or result in vision loss were recorded. Subconjunctival haemorrhage related to sub-Tenon’s anesthesia was noted in 4.3% of eyes. Five minutes after the administration of sub-Tenon’s block, 80.6% of eyes had no chemosis, 14.8% had chemosis that affected only 1 quadrant of the eye and 4.5% of eyes had chemosis affecting 2 or more quadrants of the eye. Other adverse events included 14 cases of cyst/granuloma formation in the area of sub-Tenon’s incision and 7 eyes required suturing of the conjunctival cut. Of all patients, 93.2% experienced no or only mild discomfort during or after surgical procedure.Conclusion: Sub-Tenon’s anesthesia with the use of a flexible cannula is a safe option for ophthalmic anesthesia. No sight-threatening adverse events occurred.Keywords: sub-Tenon’s anesthesia, flexible cannula, refractive lens exchange, adverse events |
| format |
article |
| author |
Lerch D Venter JA James AM Pelouskova M Collins BM Schallhorn SC |
| author_facet |
Lerch D Venter JA James AM Pelouskova M Collins BM Schallhorn SC |
| author_sort |
Lerch D |
| title |
Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| title_short |
Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| title_full |
Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| title_fullStr |
Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| title_full_unstemmed |
Outcomes and Adverse Events of Sub-Tenon’s Anesthesia with the Use of a Flexible Cannula in 35,850 Refractive Lens Exchange/Cataract Procedures |
| title_sort |
outcomes and adverse events of sub-tenon’s anesthesia with the use of a flexible cannula in 35,850 refractive lens exchange/cataract procedures |
| publisher |
Dove Medical Press |
| publishDate |
2020 |
| url |
https://doaj.org/article/73bdfc4635154ca495ad5ccc2370665b |
| work_keys_str_mv |
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