Abstract
To compare the use of topical anesthesia and retrobulbar anesthesia during silicone oil removal with a mixed pars plana technique, through evaluating the pain experience of patients. We selected patients according to their behavior during previous vitreoretinal surgery and ophthalmologic examinations and divided them into two anesthesia groups: topical (n=36) and retrobulbar (n=33). We used a mixed technique for the passive removal of silicone oil in both groups. During each step of the surgery, the patients' pain experience and the surgeon's comfort were scored according to a pain scale. The pain experienced during the application of the anesthesia was significantly greater in the retrobulbar group (p<0.001). The topical group experienced greater pain during trocar insertion (p<0.001). There was no significant difference between the groups regarding the overall pain experience or complications. The pain experience of the selected patients during silicone oil removal was comparable between the topical and the retrobulbar anesthesia. Topical anesthesia with the mixed pars plana technique is an effective and safe alternative option for silicone oil removal surgery.
Highlights
During vitreoretinal surgery for complex cases, surgeons generally use silicone oil tamponade[1]
The procedures were explained to the patients, and they were told they may experience some pain during silicone oil removal and the administration of the retro bulbar block; all patients subsequently provided written informed consent
Several surgical techniques have been described for silicone oil removal[7,8,9,10,15,16]
Summary
During vitreoretinal surgery for complex cases, surgeons generally use silicone oil tamponade[1]. Its use is associated with several complications, including cataracts, keratopathy, corneal endothelial decompen sation, glaucoma, and hypotony. It is recom mended that the silicone oil is removed as soon as possible after achieving retinal stability[3,4,5,6]. Transconjunctival sutureless systems result in faster healing, do not require sutures, and result in less discomfort to the patient. This content is licensed under a Creative Commons Attributions 4.0 International License
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