A comparison between topical and retrobulbar anesthesia in 27-gauge vitrectomy for vitreous floaters: a randomized controlled trial

Rong Han Wu, Rui Zhang, Zhong Lin, Qi Hua Liang, Nived Moonasar, Rong Han Wu, Rui Zhang, Zhong Lin, Qi Hua Liang, Nived Moonasar

Abstract

Background: To compare the safety and efficacy of topical anesthesia versus retrobulbar anesthesia in 27-gauge pars plana vitrectomy (PPV) for vitreous floaters.

Methods: 30 patients with vitreous floaters were randomized into Group T (topical anesthesia, proparacaine eye drop) and Group R (retrobulbar anesthesia), and underwent 27-gauge PPV. A 5-point visual analogue pain scale (VAPS) was used to assess patients' pain experience of anesthesia and surgery procedure (during surgery, 2 h and 1 day after surgery).

Results: The VAPS of anesthesia procedure was 1.27 ± 0.59 for patients in Group R, while it was all 0 for patients in Group T (p < 0.001). There was no significant difference for VAPS during surgery (Group T: 1.13 ± 0.74, Group R: 0.67 ± 0.62, p = 0.67), 2 h (Group T: 0.80 ± 1.01, Group R: 0.67 ± 0.62, p = 0.67) and 1 day (Group T: 0.20 ± 0.41, Group R: 0.27 ± 0.46, p = 0.68) after surgery between these two groups. Only one patient (6.7%) in Group T required additional topical anesthesia during the surgery. Most of the patients reported the pain experience came from initial trocar insertion in both groups. None of the patients required post operative analgesia in both groups. No intraoperative or postoperative complications were noted in both groups.

Conclusion: This study suggested that topical anesthesia is a safe and effective anesthetic approach for patients with floaters who underwent 27-gauge PPV.

Trial registration: ClinicalTrials.gov NCT03049163 . Registered 8 February 2017.

Keywords: 27-gauge; Pars plana vitrectomy; Retrobulbar anesthesia; Topical anesthesia.

Conflict of interest statement

Ethics approval and consent to participate

The study followed the tenets of the Declaration of Helsinki and was approved by the Ethics Committee of the Eye Hospital of Wenzhou Medical University (KYK [2016] 34). Written, informed-consent of patients was obtained.

Consent for publication

Not Applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
a Visual Analogue Pain Scale (VAPS) during anesthesia process. b Visual Analogue Pain Scale (VAPS) during surgery process. c Visual Analogue Scale (VAS) for surgeon’s comfort. d Visual Analogue Pain Scale (VAPS) 2 h after surgery. e Visual Analogue Pain Scale (VAPS) 1 day after surgery

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