Clear-Corneal Phacoemulsification with Conventional and New Anesthetic Techniques

T. Atisub M.D,
C. Thongplengsri M.D,
S. Srisuwannaporn M.D,
Department of Ophthalmology, Priest Hospital, Bangkok, Thailand

ABSTRACT
From October 1991 to September 1993 the authors performed 1,517 cataract opera tions using. the new no-stitch, clear-corneal phacoemulsification technique. A corneal-tunnel incision 3-4 mm. (width), 1.5-2 mm. (length) was made.

Of the total cases, 1,097 operations were performed by retrobulbar block, peribulbar block or general anesthesia. Since October l992, in 420 selected cases, operations were performed under topical anesthesia alone or combined with subconjunctival anesthesia, sponge anesthesia or subtenon anesthesia (pinpoint 3).

The results of the operation revealed that, 1,418 cases (93.47%) had self-sealing wounds, 84 cases (5.54%) needed stromal hydration technique around the wound or air injection to obtain sealing and to maintain the anterior chamber, and 15 cases (0.99%) needed suturing. There were no instances of post operative flat anterior chamber, iris prolapse, endophthalmitis or corneal decompen sation. It was also found that the clear-corneal incision of only 3.5 - 4 mm. could reduce the curvature of the cornea in the same axis by 1.00-1.25 diopters, 3-4 months post-operatively, thus correcting pre-existing astigmatism.

Moreover these new anesthetic techniques produced effective anesthesia which enabled the surgeons to operate without difficulties. The oculomotor system was not blocked by these ariesthesia. This enabled the patients to have clear vision with no double vision after the operation. Eye pads were not needed. The patients could resume their work immediately after the operation. This new technique increased doctor - patient satisfaction.