Indications and Current Trends in Anaesthesia in Patients Undergoing Posterior Vitrectomy

Abstract

Abstract: : Purpose: General anaesthesia is normally the preferred routine for posterior vitrectomy as the surgery may be lengthy and complicated. With more ophthalmic surgery being performed on a day case basis, the role of local anaesthesia has become increasingly important for patients undergoing this type of surgery. The aim of this study was to monitor indications of posterior vitrectomy and to determine the visual outcome as well as follow the current trends of anaesthesia for this procedure. Method: This was a prospective study on 167 patients undergoing pars plana posterior vitrectomy carried out in a 16-month period with a standardized data sheet completed at surgery. Visual outcome and further ophthalmic surgery was recorded at 48 months. Results: The sample size was 167 patients with the commonest indications being retinal detachments (46%), macular hole (23%) and vitreous haemorrhage (12%). The average age was 63 ranging from 5 to 97 years, There was a fairly even distribution between the local anaesthesia (45%) compared to general anaesthesia (55%) patients. Majority of patients undergoing posterior vitrectomy under local anaesthesia had a shorter length of stay. The mean difference in duration of the operation between both groups was 11.5 minutes. There was no difference in visual outcome in either group. Conclusion: Posterior vitrectomy is gaining popularity as a primary treatment for retinal detachment. Local anaesthetic is associated with faster recovery in patients undergoing posterior vitrectomy. It is associated with good quality of care for patients who are suitable candidates. The use of Local anaesthesia compared to general did not significantly affect visual outcome. Local anaesthesia for selected patients provides a safe alternative and allows faster recovery.

Keywords: vitreoretinal surgery • clinical (human) or epidemiologic studies: out • retina