New anesthetic approach in glaucoma surgery: “Underbleb” subtenonian anesthesia and its influence in medium term outcome

Abstract

Abstract Purpose To present a new anterior subtenonian anesthesia approach in the area of the future filtration bleb and its influence on medium term surgical success. Material and methods Retrospective study of 97 surgeries, deep sclerectomy (DS) or phaco-deep sclerectomy (PHACO-DS), were performed in patients with open angle glaucoma (OAG) comparing our modified “underbleb” subtenonian anesthesia (USA) (n = 58) versus a control group under peribulbar anesthesia (PA) (n = 38). Main outcomes were intraocular pressure (IOP), number of antiglaucomatous drugs and total and qualificated success, compared during 1, 3, 6, 12, 18 and 24 months follow up after glaucoma surgery. Results Both groups were comparable in terms of age, gender, surgical technique, number of antiglaucoma drugs and preoperative IOP. The IOP in the USA group decreased as in PA control group without statistical significant differences except at 24 months, where the IOP was 2 mm lower (14.83 ± 2.87 vs. 17.61 ± 4.27 (p = 0.009). This happened for both, DS and PHACO-DS surgeries. The number of postoperative drugs was lower at 3, 6, and 18 months but without statistically significant diferences. Tottal success at 24 months was higher in the ASA group respect AP control group (62.5% vs. 51.6) as well as partial success (100% vs. 71%). Conclusions Our new USA anesthetic technique doesn`t have a negative impact in deep sclerectomy medium-term surgical success, even it could contribute to it´s longer-term improvement.