Local Anesthesia With Blunt Sub-Tenon's Cannula Versus Sharp Retrobulbar Needle for Vitreoretinal Surgery: A Retrospective, Comparative Study

Ophthalmic Surg Lasers Imaging Retina. 2016 Jan;47(1):55-9. doi: 10.3928/23258160-20151214-08.

Abstract

Background and objective: To evaluate the safety and efficacy of a blunt sub-Tenon's cannula for local anesthesia before vitreoretinal surgery compared to a sharp retrobulbar needle.

Patients and methods: Retrospective, comparative study of all patients undergoing vitreoretinal surgery at the Medical College of Wisconsin between August 2009 and November 2013. Institutional review board approval was obtained.

Results: Of 940 surgeries performed with a sub-Tenon's cannula, 99% (938 of 940) were completed. Of the 771 surgeries performed with a sharp retrobulbar needle, 99% (770 of 771) were completed. Factors associated with use of a sharp retrobulbar needle over sub-Tenon's cannula were presence of prior scleral buckle (P < .01) and inclusion of scleral buckle placement in the procedure (P < .01). No case of globe perforation, severe retrobulbar hemorrhage, or severe conjunctival chemosis was observed in either group.

Conclusion: Blunt sub-Tenon's cannula appears as effective and safe as a sharp retrobulbar needle for local anesthesia during vitreoretinal surgery. Vitreoretinal surgeons may wish to consider a blunt sub-Tenon's cannula for local surgical anesthesia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / instrumentation*
  • Anesthesia, Local / methods
  • Anesthetics, Local / administration & dosage*
  • Catheters*
  • Female
  • Humans
  • Lidocaine / administration & dosage
  • Male
  • Middle Aged
  • Needles*
  • Retrospective Studies
  • Tenon Capsule / drug effects
  • Vitreoretinal Surgery*
  • Young Adult

Substances

  • Anesthetics, Local
  • Lidocaine