Local anesthesia effective for some open globe injuries

MIAMI — Local anesthesia with intravenous sedation is a reasonable alternative to general anesthesia in selected patients with open globe injuries, according to a study.

Ingrid Scott, MD, MPH, and colleagues reviewed the records of all adult patients with reparable open globe injuries repaired over a 5-year period at Bascom Palmer Eye Institute. They identified 220 eyes of 218 patients that met the criteria. General anesthesia was used in 80 eyes and local anesthesia/sedation was used in 140.

Patients given local anesthesia/sedation were significantly more likely to have an intraocular foreign body, better presenting visual acuity, more anterior wound location, shorter wound length and dehiscence of previous surgical wound than patients given general anesthesia. The local anesthesia group was significantly less likely to have a afferent pupillary defect. Mean surgery time was significantly shorter in the local/sedation group.

Neither group suffered any anesthesia-related complications. Change in visual acuity between the presenting and final examinations was similar in both groups.

The study is published in the November issue of American Journal of Ophthalmology.