effect of retrobulbar anaesthesia on intraocular pressure and ocular blood flow

To study the effect of retrobulbar anaesthesia on intraocular presssure [lOP] and ocular blood flow [OBF]. Fourty eyes of 40 patients [who were prepared for cataract surgery] received retrobulbar anaesthesia. The patients were divided into 2 groups: group I [retrobulbar anaesthesia without hyaluronidase] and group II [retrobulbar anaesthesia with hyaluronidase]. We measured intraocular pressure [by applanation tonometry] as well as blood flow velocity and resistivity index of central retinal artery and short posterior ciliary arteries [by Doppler sonography] just before anaesthesia, I minute after anaesthesia, and 10 minutes after anaesthesia. Both groups showed significant elevations of intraocular pressure after 1 minute of anaesthetia: group I [+ 17.9% +/- 3.7%] and group II [+ 15.8% +/- 3.3%]. However, the intraocular pressure nearly returned back to its pre-anaesthetic measurement after 10 minutes of anaesthesia. As well, both groups showed significant reductions of ocular blood flow. Group I patients [retrobulbar anaesthesia without hyaluronidase] showed a significant drop of peak systolic velocity in both central retinal artery [- 26.6% +/- 8.0%] and short posterior ciliary arteries [- 18.8% +/- 5.2%] in the 1 minute post-anaesthetic measures, as well as a significant drop of peak systolic velocity in both central retinal artery [- 30.5% +/- 7.0%] and short posterior ciliary arteries [- 22.1% +/- 13.9%] in the 10 minute post-anaesthetic measures. Group II patients [retrobulbar anaesthesia with hyaluronidase] showed a significant drop of peak systolic velocity in both central retinal artery [- 22,0% +/- 6.9%] and short posterior ciliary arteries [- 15.1% +/- 5.9%] in the 1 minute post-anaesthetic measures, as well as a significant drop of peak systolic velocity in both central retinal artery [- 26.4% +/- 13.9%] and short posterior ciliary arteries [- 17.2% +/- 10.3%] in the 10 minute post-anaesthetic measures, Retrobulbar anaesthesia results in the reduction of both choroidal and retinal blood flows. Retrobulbar anaesthesia might carry the risk of visual loss in patients with compromised ocular blood flow before surgery. It may be safer to use other anaesthetic techniques [e.g. topical or subconjunctival] in patients with ocular vascular compromise

effect of retrobulbar anaesthesia on intraocular pressure and ocular blood flow

The aim of this work was to study the effect of retrobulbar anesthesia on intraocular pressure [IOP] and ocular blood flow [OBF]. Forty eyes of 40 patients [who were prepared for cataract surgery] received retrobulbar anesthesia. The patients were divided into two groups: Group I, retrobulbar anesthesia without hyaluronidase and group II, retrobulbar anesthesia with hyaluronidase. The study measured the intraocular pressure [by applanation tonometry] as well as blood flow velocity and resistivity index of the central retinal artery and short posterior ciliary arteries [by Doppler sonography] just before anesthesia, one minute after anesthesia and ten minutes after anesthesia. The study concluded that retrobulbar anesthesia results in the reduction of both choroidal and retinal blood flows. Retrobulbar anesthesia might carry the risk of visual loss in patients with compromised ocular blood flow before surgery. It may be safer to use other anesthetic techniques [e.g. topical or subconjunctival] in patients with ocular vascular compromise

role of ultrasonograhy in the differentiation of different types of cataract snd in the assessment of nuclear hardness

The aim of this work was to evaluate the role of standardized A-scan as well as B-scan ultrasonography in the differentiation between different types of cataract as well as in the assessment of nuclear hardness. Fifty eyes with senile cataract were examined to determine its clinical type [nuclear, cortical or posterior subcapsular] and the grading of nuclear hardness. Then, the examined eyes were analyzed with standardized A-scan echographic as well as B-scan echographic examinations. Then, the echographic patterns were correlated with the clinical types. The study concluded that standardized A-scan might be helpful in the assessment of nuclear hardness, especially in white cataract. B-scan ultrasonography was less reliable in determining the type of cataract

Peribulbar anesthesia with Ropivacaine in strabismus surgery

To study the efficacy of ropivacaine in peribulbar injection for strabismus surgery and to evaluate its selectivity between sensory and motor blockade. Sixty patients ranging in age from 16-70 years underwent strabismus surgery under local anesthesia. Patients were given ropivacaine 0.2 percent [2 mg/ml] with hyaluorinidase 10 Iu/ml in peribulbar injection. Ocular motility was checked during surgery. During surgery all patients never expressed any pain but the ocular motility was limited. Ropivacaine is effective in peribulbar injection for strabismus surgery. Benefit of this technique, avoidance of certain hazards of general anesthesia and intraoperative muscle adjustment of selected cases of squint with large angle