Macular hole surgery under retrobulbar local anesthesia increases visual acuity
Abstract: Macular hole surgery
can be done under general or local anesthesia, and general anesthesia is still
the standard procedure. The objective of this study was to investigate the
results of macular hole surgery under local anesthesia.
Methods
A retrospective study on medical records of patients who had undergone
macular hole surgery under local anesthesia. Funduscopic examination of macular
hole had been performed and all other diseases with deterioration of visual
acuity eliminated. Surgery was performed under retrobulbar local anesthesia,
using 2 ml of 2% lidocaine mixed with 3 ml bupivacaine in one syringe. Vitreous
tamponade used 20% sulfur hexafluoride (SF6). Demographic and clinical
characteristics, visual acuity before and after surgery, and improvements that
occurred were assessed.
Results
No significant interruption occurred during surgery. Mean age of the patients
was 53.89 ± 13.3 years (22-74 years), with mean duration of symptoms of 48.83 ±
100.51 weeks (1-560 weeks). The patients comprised 20 males (55.6%) and 16
females (44.4 5). There were improvements in visual acuity after surgery in 31
patients (86.1%), the rest (13.9%) had identical or lower visual acuity after
surgery. A total of 20 patients (55.6%) had postoperative visual acuity of 6/18
or better. Initial mean preoperative visual acuity was 0.08 ± 0.08 (0.01 -
0.29) and improved after the surgery to 0.38 ± 0.26 (0.00 - 1.00), the
improvement being statistically significant (p=0.000).
Conclusion
Retrobulbar anesthesia is an effective and safe method in macular hole
surgery. Macular hole surgery can be done well under local anesthesia, and
visual acuity improved significantly.
Keywords: Macular hole;
anesthesia; blindness; visual acuity; vitrectomy
Author: Gilbert WS
Simanjuntak, Golda AM Simanjuntak, Reinne Natali Christine
Journal Code: jpkedokterangg170054
