Clear-Corneal
Phacoemulsification with Conventional and New Anesthetic Techniques
T. Atisub
M.D,
C. Thongplengsri M.D,
S. Srisuwannaporn M.D,
Department of
Ophthalmology, Priest Hospital, Bangkok, Thailand
ABSTRACT
From
October 1991 to September 1993 the authors performed 1,517 cataract opera
tions using. the new no-stitch, clear-corneal phacoemulsification technique.
A corneal-tunnel incision 3-4 mm. (width), 1.5-2 mm. (length) was made.
Of the total cases, 1,097
operations were performed by retrobulbar block, peribulbar block or general
anesthesia. Since October l992, in 420 selected cases, operations were performed
under topical anesthesia alone or combined with subconjunctival anesthesia,
sponge anesthesia or subtenon anesthesia (pinpoint 3).
The results of the operation
revealed that, 1,418 cases (93.47%) had self-sealing wounds, 84 cases (5.54%)
needed stromal hydration technique around the wound or air injection to obtain
sealing and to maintain the anterior chamber, and 15 cases (0.99%) needed
suturing. There were no instances of post operative flat anterior chamber,
iris prolapse, endophthalmitis or corneal decompen sation. It was also found
that the clear-corneal incision of only 3.5 - 4 mm. could reduce the curvature
of the cornea in the same axis by 1.00-1.25 diopters, 3-4 months post-operatively,
thus correcting pre-existing astigmatism.
Moreover these new anesthetic
techniques produced effective anesthesia which enabled the surgeons to operate
without difficulties. The oculomotor system was not blocked by these ariesthesia.
This enabled the patients to have clear vision with no double vision after
the operation. Eye pads were not needed. The patients could resume their work
immediately after the operation. This new technique increased doctor - patient
satisfaction.
Thai J Ophthalmol 1993
; July - December 7(2): 115-127 |