表面麻醉下27G玻璃体切除术治疗有症状的玻璃体混浊
27-Gauge Vitrectomy for Symptomatic Vitreous Floaters with Topical Anesthesia.
作者信息
Lin Zhong, Moonasar Nived, Wu Rong Han, Seemongal-Dass Robin R
机构信息
The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
Ophthalmology Department, University of the West Indies, St. Augustine, Trinidad and Tobago.
出版信息
Case Rep Ophthalmol. 2017 Jan 20;8(1):35-39. doi: 10.1159/000453332. eCollection 2017 Jan-Apr.
PURPOSE
Traditionally acceptable methods of anesthesia for vitrectomy surgery are quite varied. However, each of these methods has its own potential for complications that can range from minor to severe. The surgery procedure of vitrectomy for symptomatic vitreous floaters is much simpler, mainly reflecting in the nonuse of sclera indentation, photocoagulation, and the apparently short surgery duration. The use of 27-gauge cannulae makes the puncture of the sclera minimally invasive. Hence, retrobulbar anesthesia, due to its rare but severe complications, seemed excessive for this kind of surgery.
METHOD
Three cases of 27-gauge, sutureless pars plana vitrectomy for symptomatic vitreous floaters with topical anesthesia are reported.
RESULTS
The vitrectomy surgeries were successfully performed with topical anesthesia (proparacaine, 0.5%) without operative or postoperative complications. Furthermore, none of the patients experienced apparent pain during or after the surgery.
CONCLUSION
Topical anesthesia can be considered for 27-guage vitrectomy in patients with symptomatic vitreous floaters.
目的
传统上，玻璃体切除术可接受的麻醉方法多种多样。然而，这些方法中的每一种都有其自身发生并发症的可能性，并发症的严重程度从轻微到严重不等。有症状性玻璃体混浊的玻璃体切除术手术过程要简单得多，主要体现在不使用巩膜压陷、光凝，且手术持续时间明显较短。27G套管针的使用使巩膜穿刺微创化。因此，球后麻醉由于其罕见但严重的并发症，对于这类手术来说似乎有些过度。
方法
报告3例采用表面麻醉进行有症状性玻璃体混浊的27G无缝线玻璃体切除术。
结果
表面麻醉（0.5%丙美卡因）下成功进行了玻璃体切除术，无手术或术后并发症。此外，所有患者在手术期间或术后均未经历明显疼痛。
结论
有症状性玻璃体混浊患者的27G玻璃体切除术可考虑采用表面麻醉。
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