Diabetic Retinopathy and its Impact on Ocular Heamodynamics during Local Anesthesia Comparing Peribulbar and Subtenon in Phacoemulsification,
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- Category: Vol. 84, December 2016
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Diabetic Retinopathy and its Impact on Ocular Heamodynamics during Local Anesthesia Comparing Peribulbar and Subtenon in Phacoemulsification, ASHRAF R. ASSWA, SAMY ELSAYEH, MOHAMMED YOSRY, MOHAMED EL-MALT and OMNEYA FOUAD
Abstract
Background: The changes in intraocular pressure (IOP) during anesthesia and different anesthetic techniques which affect the retinal blood flow especially in affected impaired retinal perfusion as in diabetes.
Aim of the Work: To compare the efficacy of subtenon with peribulber local anesthesia in diabetic retinopathy patient undergoing cataract surgery as they had compromised retinal perfusion who may had damaged optic disc any transient increase in intraocular pressure or reduction in retinal blood flow may lead to loss of remaining central vision. The effect of Regional anesthesia on retinal blood flow had not been studied before in diabetic retinopathy patients.
Study Design: A randomized controlled trial.
Methodology: Eighty patients included in this study were randomly assigned to one of 4 groups divided into 2 groups receiving subtenon block and other 2 groups receiving peribul-bar block. Peak systolic velocity was measured immediately before the block, after 1 minute and after 10 minutes of injection of the local anesthetic. Also, IOP, the other parameters measured by the color Doppler imaging including end diastolic velocity, mean vascular pressure, pulsatility index and resis-tivity index, and the incidence of complications were recorded.
Results: There was significant difference in drop of varients (PSV, EDV, MV, PI) which might put the eye in critical situation.
Conclusion: Subtenon anesthesia provides smaller reduc-tion in retinal blood flow.