Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study
Abstract Background To determine the safety and feasibility of sutureless pars-plana vitrectomy (ppV) in sub-Tenon anesthesia. Methods In this prospective study. Pain and anxiety at various times after ppV using a visual analogue scale (VAS) and Wong-Baker-FACES scale as well as visual sensations du...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | European Journal of Medical Research |
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| Online Access: | https://doi.org/10.1186/s40001-023-01447-2 |
| _version_ | 1797637031388512256 |
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| author | Tibor Lohmann Sabine Baumgarten Julia Prinz Peter Walter Antonis Koutsonas |
| author_facet | Tibor Lohmann Sabine Baumgarten Julia Prinz Peter Walter Antonis Koutsonas |
| author_sort | Tibor Lohmann |
| collection | DOAJ |
| description | Abstract Background To determine the safety and feasibility of sutureless pars-plana vitrectomy (ppV) in sub-Tenon anesthesia. Methods In this prospective study. Pain and anxiety at various times after ppV using a visual analogue scale (VAS) and Wong-Baker-FACES scale as well as visual sensations during surgery were investigated. The surgeon evaluated motility, chemosis, overall feasibility. Results ppV was performed on 67 eyes (33 sub-Tenon anesthesia, 34 general anesthesia). Pain during surgery in sub-Tenon anesthesia was 1.8 ± 2.2 (0.0–8.0), anxiety was 2.3 ± 2.2 (0.0–8.5). There was a moderate correlation between pain and anxiety (R 2 = 0.58). Comparing sub-Tenon and general anesthesia no difference in pain perception was found the day after surgery. 27.3% of patients saw details, 21.2% saw colors, 90.1% saw light/motion perception, 3.0% had no light perception. Median chemosis after surgery was 1.0 (IQR = 1.0). Median motility of the eye during surgery was 1.0 (IQR = 1.0), median grade was 1.0 (IQR = 1.0). 24.2% of patients showed subconjunctival hemorrhage during or after surgery. Conclusions Sutureless pars-plana vitrectomy in sub-Tenon anesthesia was performed safely, with pain and anxiety levels tolerable for the patients and without the necessity for presence of an anesthesiologist. With 88.9% of patients willing to undergo vitreoretinal surgery in sub-Tenon anesthesia again, we recommend it as a standard option. Trial registration This study was approved by the Institutional Ethical Review Board of the RWTH Aachen University (EK 111/19). This study is listed on clinicaltrials.gov (ClinicalTrials.gov identifier: NCT04257188, February 5th 2020). |
| first_indexed | 2024-03-11T12:42:32Z |
| format | Article |
| id | doaj.art-37b06543eeda4628b6329a8cdee429a5 |
| institution | Directory Open Access Journal |
| issn | 2047-783X |
| language | English |
| last_indexed | 2024-03-11T12:42:32Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | European Journal of Medical Research |
| spelling | doaj.art-37b06543eeda4628b6329a8cdee429a52023-11-05T12:11:20ZengBMCEuropean Journal of Medical Research2047-783X2023-10-0128111010.1186/s40001-023-01447-2Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective studyTibor Lohmann0Sabine Baumgarten1Julia Prinz2Peter Walter3Antonis Koutsonas4Department of Ophthalmology, RWTH Aachen UniversityDepartment of Ophthalmology, RWTH Aachen UniversityDepartment of Ophthalmology, RWTH Aachen UniversityDepartment of Ophthalmology, RWTH Aachen UniversityDepartment of Ophthalmology, RWTH Aachen UniversityAbstract Background To determine the safety and feasibility of sutureless pars-plana vitrectomy (ppV) in sub-Tenon anesthesia. Methods In this prospective study. Pain and anxiety at various times after ppV using a visual analogue scale (VAS) and Wong-Baker-FACES scale as well as visual sensations during surgery were investigated. The surgeon evaluated motility, chemosis, overall feasibility. Results ppV was performed on 67 eyes (33 sub-Tenon anesthesia, 34 general anesthesia). Pain during surgery in sub-Tenon anesthesia was 1.8 ± 2.2 (0.0–8.0), anxiety was 2.3 ± 2.2 (0.0–8.5). There was a moderate correlation between pain and anxiety (R 2 = 0.58). Comparing sub-Tenon and general anesthesia no difference in pain perception was found the day after surgery. 27.3% of patients saw details, 21.2% saw colors, 90.1% saw light/motion perception, 3.0% had no light perception. Median chemosis after surgery was 1.0 (IQR = 1.0). Median motility of the eye during surgery was 1.0 (IQR = 1.0), median grade was 1.0 (IQR = 1.0). 24.2% of patients showed subconjunctival hemorrhage during or after surgery. Conclusions Sutureless pars-plana vitrectomy in sub-Tenon anesthesia was performed safely, with pain and anxiety levels tolerable for the patients and without the necessity for presence of an anesthesiologist. With 88.9% of patients willing to undergo vitreoretinal surgery in sub-Tenon anesthesia again, we recommend it as a standard option. Trial registration This study was approved by the Institutional Ethical Review Board of the RWTH Aachen University (EK 111/19). This study is listed on clinicaltrials.gov (ClinicalTrials.gov identifier: NCT04257188, February 5th 2020).https://doi.org/10.1186/s40001-023-01447-2RetinaRetinal surgeryVitreoretinal surgeryLocal anesthesiaSub-Tenon anesthesiaGeneral anesthesia |
| spellingShingle | Tibor Lohmann Sabine Baumgarten Julia Prinz Peter Walter Antonis Koutsonas Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study European Journal of Medical Research Retina Retinal surgery Vitreoretinal surgery Local anesthesia Sub-Tenon anesthesia General anesthesia |
| title | Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study |
| title_full | Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study |
| title_fullStr | Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study |
| title_full_unstemmed | Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study |
| title_short | Safety and feasibility of sutureless pars-plana vitrectomy in sub-Tenon anesthesia (SAFE-VISA): a prospective study |
| title_sort | safety and feasibility of sutureless pars plana vitrectomy in sub tenon anesthesia safe visa a prospective study |
| topic | Retina Retinal surgery Vitreoretinal surgery Local anesthesia Sub-Tenon anesthesia General anesthesia |
| url | https://doi.org/10.1186/s40001-023-01447-2 |
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