[Subconjunctival or general anaesthesia in trabeculectomy--a retrospective analysis of the bleeding risk from a glaucoma surgeon's point of view].

Abstract

INTRODUCTION:

The aim of this study was to compare the intraoperative and early postoperative outcome of trabeculectomy with mitomycin C in glaucoma patients undergoing general anaesthesia compared to those undergoing subconjunctival anaesthesia.

METHODS:

The perioperative results of consecutive glaucoma patients receiving a trabeculectomy with mitomycin C either under general anaesthesia (group 1, n = 60) or in subconjunctival anaesthesia (group 2, n = 60) were analysed in a retrospective study. All surgical procedures were performed by one surgeon and only one eye of each patient with no history of previous conjunctival surgery was included in the study.

RESULTS:

No significant peri- and postoperative differences concerning period of hospitalisation, intraocular pressure, filtration-bleb bleedings, hyphaema, frequency of laser suture lysis, hypotony, chorioidal detachment or revision surgery could be shown between the two groups. Considering all patients together, there was a significant correlation between the occurrence of postoperative filtering bleb bleedings and the absolute number of topical antiglaucomatous substances used prior to surgery.

CONCLUSIONS:

The perioperative risk profile of penetrating glaucoma surgery with subconjunctival anaesthesia seems to be similar to that of procedures under general anaesthesia. For prevention of postoperative filtering bleb bleedings, the administration of topical antiglaucomatous drugs should be stopped before surgery.

• Authors: T S Dietlein, Y Moalem, A M Schild, A Lappas, A Rosentreter, S Dinslage
• Journal: Klinische Monatsblatter fur Augenheilkunde (Klin Monbl Augenheilkd) Vol. 229 Issue 8 Pg. 826-9 (Aug 2012) ISSN: 1439-3999 [Electronic] Germany
• Vernacular Title: Subkonjunktivalanästhesie oder Vollnarkose bei der Trabekulektomie--retrospektive Analyse des perioperativen Blutungsrisikos aus Sicht des Glaukomchirurgen.
• PMID: 22553137 (Publication Type: Comparative Study, English Abstract, Journal Article)
• Copyright: © Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Aged
• Anesthesia, General
• Anesthesia, Local (statistics & numerical data)
• Comorbidity
• Eye Hemorrhage (epidemiology)
• Female
• Germany (epidemiology)
• Glaucoma (epidemiology)
• Humans
• Male
• Middle Aged
• Postoperative Hemorrhage (epidemiology)
• Prevalence
• Retrospective Studies
• Risk Assessment
• Trabeculectomy (statistics & numerical data)
• Treatment Outcome