Đánh giá hiệu quả phương pháp gây tê bề mặt nhãn cầu trong phẫu thuật đục thể thủy tinh bằng phương pháp nhũ tương hóa tại bệnh viện Chợ Rẫy

Objectives:To assess the safety and effectiveness of ocular surface topical anesthesia using collyre tetracaine 0.5 percent in phacoemulsification for cataracts. Procedure to perform local anesthesia of the ocular surface. Indications of local anesthesia on the ocular surface with collyre tetracaine 0.5 percent. Materials and methods.Subjects: Cataract patients or = 16 years of age, receiving phacoemulsification procedure with intraocular soft lens placement, local anesthesia.Methods:Longitudinal; observation of multiple cases of traumatic cataracts presented at the Department of Ophthalmology, Cho Ray Hospital, from 01/1/2011 to 31/12/2011. Patients received using 0.5 percent tetracaine hydrochloride eyedrops, with or without oral diazepam smg given 30 minutes to 60 minutes before surgery. Results:Patients eligible to participate in the study: 498 patients, Male: 199 (39.9 percent) Female: 299 (60.1 percent). Lowest age is 20, highest 88, average age 62.1 + or - 13.5. Local drops of collyre tetracaine 0.5 percent: 368 patients, with 166 receiving oral diazepam smg before surgery. Procedure duration: from 12 minutes to 30 minutes, with an average of 18.6 + or - 3.7 minutes. Patients with no pain reported during surgery: 90.8 percent. Patients with mild pains which did not affect the operation: 6.8 percent. Patients with complete satisfaction: 92.6 percent, unsatisfied patients: 1.4 percent. Surgical complications were reported in 4.4 percent of cases. Among the complications, increased IOP were reported in 2.4 percent of cases. However, the complications did not affect the procedure. Other complications include capsular rupture; 0.8 percent, vitreous prolapse: 0.6 percent.Vision improved well after 24 hours with 83.7 percent (417/498) of patients having vision 5/10. Conclusions:Local anesthesia using collyre tetracaine 0.5 percent eyedrops in phacoemulsification for cataracts in adults yields good results. 2.2 percent of patients had mild pains and 0.2 percent had severe pains, which could be relieved by 1 or 2 extra doses. There was no reported side effect complicating the procedure. Complications seen while using other methods of anesthesia can be avoided. Method and dosage: 3 times daily, 2 drops at a time, 5 minutes apart, before surgery. During surgery if the patient experiences pain, 1 or 2 additional doses can be used. Proper explanation of the surgical procedures, effects and benefits of this method of anesthesia to patients is very important.Local anesthesia with drops of tetracaine 0.5 percent is one of the safety anesthetic methods which can be used for adult patients who cooperate and have no contraindication to the drug.