RESUMO
ABSTRACT - Capsular block syndrome is a rare complication of phacoemulsification surgery with continuous curvilinear capsulorhexis and intraocular lens implantation. Here, we report a case of very late-onset capsular block syndrome that developed 13 years after cataract extraction and present the surgical approach used for its successful treatment.
RESUMO - Síndrome do bloqueio capsular é uma complicação incomum da cirurgia de facoemulsificação com capsulorrexis curvilínea contínua e implante de lente intraocular. Nós relatamos um caso de síndrome de bloqueio capsular de início tardio que se desenvolveu após 13 anos da extração da catarata e apresenta a abordagem cirúrgica utilizada para o sucesso do tratamento.
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Facoemulsificação/efeitos adversos , Capsulotomia Posterior/métodos , Cápsula do Cristalino/cirurgia , Doenças do Cristalino/cirurgia , Doenças do Cristalino/etiologia , Complicações Pós-Operatórias/cirurgia , Síndrome , Acuidade Visual , Resultado do Tratamento , Tomografia de Coerência Óptica , Transtornos de Início Tardio/etiologia , Cápsula do Cristalino/diagnóstico por imagem , Doenças do Cristalino/diagnóstico por imagem , Lentes Intraoculares/efeitos adversosRESUMO
Capsular block syndrome is a rare complication of phacoemulsification surgery with continuous curvilinear capsulorhexis and intraocular lens implantation. Here, we report a case of very late-onset capsular block syndrome that developed 13 years after cataract extraction and present the surgical approach used for its successful treatment.
Assuntos
Cápsula do Cristalino/cirurgia , Doenças do Cristalino/etiologia , Doenças do Cristalino/cirurgia , Facoemulsificação/efeitos adversos , Capsulotomia Posterior/métodos , Feminino , Humanos , Transtornos de Início Tardio/etiologia , Cápsula do Cristalino/diagnóstico por imagem , Doenças do Cristalino/diagnóstico por imagem , Lentes Intraoculares/efeitos adversos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/cirurgia , Síndrome , Tomografia de Coerência Óptica , Resultado do Tratamento , Acuidade VisualRESUMO
PURPOSE: To compare the efficacy of different concentrations of topical lidocaine gel with standard subconjunctival anesthesia. METHODS: This was a prospective randomized controlled pilot study with 3 different groups. Group SC received subconjunctival lidocaine and proparacaine drops as needed during surgery. Group L2 received 2% lidocaine gel and group L5 received 5% lidocaine gel. Both lidocaine gel groups could receive another gel dose as needed during the procedure. The primary outcome was pain, which was experienced during and after surgery. The assessment was done using a 10-point linear analog scale at predetermined stages of surgery (1-first incision, 2-pterygium body excision, 3-conjunctival suturing, 4-immediate postoperative period after patching, and 5-assessment by a trained nurse in the absence of a surgeon after operation). RESULTS: We enrolled 45 consecutive patients who underwent primary pterygium surgery. Statistical significance between groups was found in mean pain at administration (2.2 vs. 0.4 vs. 0.0 in SC, L2, and L5 groups, respectively, with P < 0.05). The number of reapplications of anesthetic drops did not differ between the groups. We found a correlation between reapplication of the anesthetic and pain at administration and duration of the procedure. CONCLUSIONS: We demonstrated that the use of lidocaine gel at concentrations of 2% and 5% in pterygium surgery was as effective as subconjunctival injection of lidocaine in reducing intraoperative and postoperative pain, producing significantly less pain during initial administration of the anesthetic.
