Chung Chong Fai, Lai Jimmy S M, Lam Dennis S C
Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong, China.
J Cataract Refract Surg. 2004 Feb;30(2):444-8. doi: 10.1016/S0886-3350(03)00612-6.
To evaluate patients' visual sensations at different stages of phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation under topical and regional anesthesia.
Department of Ophthalmology, United Christian Hospital and Tseung Kwan O Hospital, Kowloon, Hong Kong, China.
Seventy-six consecutive patients having phacoemulsification were randomized to a topical anesthesia group (n = 35) or regional anesthesia group (n = 41). The topical anesthesia group received lidocaine hydrochloride 2% gel (Xylocaine) and the regional anesthesia group, a peribulbar or retrobulbar injection of lignocaine 2%. The patients' visual sensations, including light and color sensations, shape of objects, and visual patterns, were evaluated at different stages of surgery.
Two patients (4.9%) in the regional anesthesia group and none in the topical anesthesia group experienced total loss of light sensation throughout surgery (P =.50). There was a significant association between color perception and the type of anesthesia at stages 1 and 2 (P<.05) but not at stages 3, 4, and 5 (P>.05). The perception of objects and visual patterns had no association with the type of anesthesia at any stage (P>.05). Of all patients in the study, 56 (73.7%) reported color changes as surgery proceeded. Both groups saw waves, defined as curves with periodic fluctuations in amplitude, at all stages. The perception of some colors and a rectangular moving object was significantly associated with the type of anesthesia at some or all stages (P<.05).
Patients having phacoemulsification and PC IOL implantation under topical or regional anesthesia had a wide spectrum of visual sensations that were similar at most stages of surgery. Patients in the topical anesthesia group perceived more colors at the early stages and more blue throughout surgery than patients in the regional anesthesia group.
评估在表面麻醉和区域麻醉下白内障超声乳化及后房型人工晶状体（PC IOL）植入不同阶段患者的视觉感受。
中国香港九龙联合医院及将军澳医院眼科。
76例连续接受白内障超声乳化的患者被随机分为表面麻醉组（n = 35）和区域麻醉组（n = 41）。表面麻醉组使用2%盐酸利多卡因凝胶（赛罗卡因），区域麻醉组则进行球周或球后注射2%利多卡因。在手术的不同阶段评估患者的视觉感受，包括光感和色觉、物体形状及视觉图案。
区域麻醉组有2例患者（4.9%）在整个手术过程中出现完全光感丧失，表面麻醉组无此情况（P = 0.50）。在第1和第2阶段，色觉与麻醉类型之间存在显著关联（P < 0.05），但在第3、4和5阶段无此关联（P > 0.05）。在任何阶段，物体及视觉图案的感知与麻醉类型均无关联（P > 0.05）。在所有研究患者中，56例（73.7%）报告随着手术进行出现颜色变化。两组在所有阶段均看到波形，即振幅有周期性波动的曲线。某些颜色及一个矩形移动物体的感知在部分或所有阶段与麻醉类型显著相关（P < 0.05）。
在表面麻醉或区域麻醉下接受白内障超声乳化及PC IOL植入的患者有广泛的视觉感受，在手术的大多数阶段相似。表面麻醉组患者在早期比区域麻醉组患者感知到更多颜色，且在整个手术过程中感知到更多蓝色。
