Pharmacological aspects of anaesthesia for implantation of the artificial lens.

Abstract

During the placement of an artificial lens the ophthalmic surgeon must be guaranteed an immobile operation site and so-called ‘soft eye’. Based on our experience with more than 1000 lens implantation operations in the Rotterdam Eye Hospital over the past three years, the following conclusions can be drawn: The pharmacological agents available to the anaesthetist are sufficient for providing optimal conditions under general anaesthesia for lens implantation techniques by the eye surgeon. Hypotensive techniques are not regarded as being appropriate because of the inherent risks involved. Classical neuroleptic techniques are best avoided in the elderly. Controlled ventilation is preferable in order to avoid the deleterious side effects of hypercarbia. Constant vigilance on the part of the anaesthetist during the operation is a very important ‘sine qua non’ for a tranquil course both during the anaesthetic and in the post-operative period. The routine administration of antiemetic agents after a lens implantation operation is advisable this holds true also for prevention of the Central Anticholinergic Syndrome by means of physostigmine, in patients who have received inhalation anaesthetics, particularly enflurane or, flunitrazepam.