Circumferential Perilimbal Anesthesia for Combined Cataract Glaucoma Surgery

Abstract

BACKGROUND AND OBJECTIVES: A topical-subconjunctival anesthesia technique named circumferential perilimbal anesthesia was tested in a consecutive series of 34 combined cataract and glaucoma cases to determine effectiveness in long duration anterior segment surgery. PATIENTS AND METHODS: The circumferential perilimbal technique for combined surgery involved administration of 4% topical Xylocaine drops and injection of 0.25 cc of 4% Xylocaine subconjunctivally 3-4 mm inferior to the limbus. The inferior subconjunctival anesthesia was then spread 360 degrees around the limbus circumferentially with a smooth forceps. The topical and local anesthetic was supplemented by intravenous preoperative and intraoperative sedative and analgesic medications. RESULTS: All patients had successful phacoemulsification cataract extraction with intraocular lens combined with trabeculectomy. Medical records and postoperative interviews of the combined cataract-glaucoma cases revealed an average surgery time of 46 minutes (range 35 minutes-60 minutes) and only one incident of patient intraoperative pain. CONCLUSION: The circumferential perilimbal technique was an effective anesthesia technique for long duration combined cataract and glaucoma surgery.