ABSTRACT
To determine the patients tolerability, comfort, ease of application and surgeons convenience with sub-conjunctival anaesthesia for trabeculectomy in our clinical setup. Material and It was a prospective and observational study conducted at the department of Ophthalmology, Postgraduate Medical Institute, Hayatabad Medical Complex and Khyber Teaching Hospital, Peshawar. All patients were injected with up to 1 ml of a 1:1mixture of 2% lignocain with epinephrine and 0.75% bupivacaine sub-conjunctivally and operated for trabeculectomy. Intra-operative pain, presence of eye movements and complications of anaesthesia were monitored. Bleb leak and ptosis were assessed postoperatively. Patient discomfort was assessed intraoperatively and 24 hours postoperatively using a standardized verbal descriptive chart with 0 to 4 pain scoring levels. Eighty patients underwent sub-conjunctival anaesthesia for trabeculectomy. Sixty-eight [85%] patients remained comfortable throughout the procedure. Only 3 [3.75%] patients required supplemental subconjunctival anaesthesia block during surgery, while 7 [8.75%] patients required a facial block. Two [2.5%] patients needed retrobulbar block. No surgery was postponed and none of the patient required general anesthesia. Most common complication noted was chemosis of the conjunctiva [70%]. In two cases [2.5%] it interfered with the surgery and the surgery time was prolonged. Small sub-conjunctival hemorrhage developed in 43 [53.75%] patients; however, this did not interfere with the surgery. No case of postoperative bleb leak and ptosis was noted. The technique of subconjunctival anaesthesia is safe, effective, tolerable, and convenient. It is not associated with any remarkable postoperative complications because it is performed under direct visualization