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N. Geffen, M. M. Carrillo, Y. Jin, G. E. Trope, Y. M. Buys; Effect of Local Anesthesia on Trabeculectomy Success. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4166. doi: https://doi.org/.
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Subconjunctival anesthesia has been reported to be a risk factor of poor success with trabeculectomy surgery. The purpose of this study is to compare the long-term results of trabeculectomy surgery with subconjunctival anesthesia versus topical lidocaine 2% jelly.
A retrospective review of the long-term IOP of 57 trabeculectomies previously enrolled in a prospective study comparing subconjunctival anesthesia to topical lidocaine 2% jelly. Follow-up was conducted by reviewing the medical charts from July 2002 to August 2007. Differences between the two groups were statistically assessed using the Student t test for continuous data, the chi square test or the Fisher s exact test for categorical data and the Kaplan-Meier survival analysis.
The median age was 65 years and the median follow-up time was 4.2 years for both groups (range 0.1-4.8 years). There were no statistically significant differences in baseline characteristics and follow-up observations. At 4 years following surgery, 29.5% of the subconjunctival anesthesia patients versus 39.5% of the topical lidocaine 2% jelly patients were complete success (IOP between 6-21 mmHg and 20% reduction without glaucoma therapy or repeat filtration surgery, p=0.15) and 82.7% of the subconjunctival anesthesia patients versus 95.8% for the topical lidocaine 2% jelly patients were qualified success (above with glaucoma therapy, p=0.39).
Subconjunctival anesthesia did not result in a worse prognosis for trabeculectomy in this cohort.
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