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R. Adam, T. Rodallec, J. Nordmann; Pain Evaluation During 25-Gauge Transconjunctival Sutureless Vitrectomy Under Topic Anesthesia. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2234.
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to evaluate pain during 25G transconjunctival sutureless vitrectomy under topic anesthesia (Xylocaine gel)
. 35 patients were included in this prospective study- epiretinal membranes, intravitreal hemorragies, macular holes, vitreoretinal traction syndromes, peeling of posterior hyaloid and internal limiting membrane for macular edema. All patients had topic anesthesia with Xylocaine 2% gel with propofol potentialisation 2 minutes before performing the sclerotomies. The pain was determined at the end of the intervention and 1 day after intervention. The analogous pain chart between 0 (no pain or discomfort) and 10 (severe pain and discomfort) was used.
. All groups presented pain at mean level 2.45 during and after operation. In macular hole cases the pain was graded at 4. One day after surgery all groups presented mean 0.28 pain grading. There was no complication rate. Alternatively there was a patient group under anticoagulant treatment that proved that this kind of anesthesia is a decision of choice.
With appropriate case selection, topic anesthesia is a safe and effective alternative to infiltrative anesthesia for 25Gauge transconjunctival sutureless vitrectomy. This can be advisable for patients under anticoagulants for severe cardiovascular pathology.
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