Abstract
Purpose :
The aim of this pilot, observational, prospective case series study was to assess the efficacy and safety of retrobulbar haloperidol application for pain relief in blind eyes and to explore its association with the quality of life of patients. The study was conducted at Aljaorza Ophthalmological Specialties Center in Machala city from June 2023 to the present, following the principles of the Declaration of Helsinki. Informed consent was obtained from all participants, and the study received approval from the institutional ethics committee.
Methods :
The variables under consideration included visual acuity (VA), intraocular pressure (IOP), complications during and after the procedure, and quality of life assessed using the 25-item National Eye Institute Visual Function Questionnaire (VFQ 25), among other factors. Follow-up assessments were conducted at 24 hours post-procedure, one week, one month, and three months. Data were tabulated using Excel and analyzed using the SPSS program. The surgical technique involved retrobulbar injection of anesthetic (lidocaine and bupivacaine) followed by the application of 2 cc of haloperidol (10 mg).
Results :
Seven eyes from 7 patients with painful blind eyes were included, ages were from 32 to 89 years (mean age: 59 years). Neovascular glaucoma was the most common etiological cause (42% of cases). Visual acuity ranged from no light perception in 6 cases to light perception in 1 case. Pain decreased from 8.57/10 on the Visual Analogue of Pain (EAD) scale before medication to 2/10 within the first 24 hours, sustaining this improvement even a month after treatment. Baseline IOP was 43 mmHg, reducing to 29.14 mmHg at one month follow-up. Side effects included 1 case of dizziness and nausea, resolved with antiemetic medications, and postoperative eyelid edema and sectorized ecchymosis in 2 patients, spontaneously resolving. In the VFQ 25 questionnaire, significant improvements were noted in personal interaction with relatives and friends, as well as a better self-perception and increased independence in daily activities.
Conclusions :
Retrobulbar haloperidol appears to be a promising therapeutic option for managing patients with painful blind eyes of various etiologies. While it shows apparent effectiveness and safety in this preliminary study, it is important to note that further research is needed to validate its efficacy and safety in a larger population before widespread clinical adoption.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.