gms | German Medical Science

Objectives: To evaluate outcomes and patient experience with more than 125,000 subtenon’s anaesthesia performed prior to intraocular lens implantation in 62,000 consecutive patients as an exclusively used technique.

Designs and methods: This prospective study included consecutive eyes that underwent intraocular lens implant between 2007 and 2017 with the use of subtenon’s anaesthesia. All patients received subtenon’s blocks using a plastic cannula with the aim to increase efficacy, minimize chemosis and reduce haemorrhage with a novel self invented anti-haemorrhage technique. Common eye spears are used to drain the blood caused by the incision as long as the bleeding time last. All patients received mild conscious sedation with the dosage adjusted to age, medical and general condition. Sedation was increased by 50% for second IOL procedure performed on each patient. Data on outcome and patient satisfaction were collected using a computerized proforma.

Results: Average age of the study population was 52 years. Incidence of chemosis was 5.2% and subconjunctival haemorhage was reported by 5% of patients. Of all patients, 98% claimed to be satisfied with their procedure and journey. Zero sight threatening/enduring complication, life threatening events or infections occurred.

Conclusion: Subtenon’s anaesthesia with the use of a plastic cannula, in combination with conscious sedation, provided excellent eye immobilization, positively affected patient experience, and reduced common complications associated with regional anaesthesia performed prior to intraocular lens implantation. The modernized technique had a relatively short learning curve. No severe complication occurred.

Note: No financial interest.