Zusammenfassung
Währende intraokularer Eingriffe in Retro- oder Peribulbäranästhesie stellt eine insuffiziente Anästhesie wegen Bulbusbewegungen ein grundsätzliches Problem dar, ebenso bei Operationen in Tropfanästhesie. Die Nachinjektion stellt nur eine unvollständige Lösung dar, weil dann vermehrt Glaskörperdruck auftritt. Diese Probleme können vermieden werden, wenn dem Patienten während der Operation ein Fixierlicht auf dem nichtoperierten Auge angeboten wird. In dem Falle steht der operierte Bulbus ruhig. Die Operation ist ungestört möglich, die Muskelanspannung gleichmäßig, wodurch Glaskörperdruck vermieden wird; Nachinjektionen sind nicht erforderlich. Als Fixierlicht wurde ein Diodenfeld verwendet. In dem Feld sind 70 Dioden eingebettet, welche durch eine Tastatur angesteuert werden können. Mit der Tastatur kann eine Diode ausgewählt und damit die Blickrichtung beeinflußt werden. Mit dieser Apparatur war es auch bei vorliegender Katarakt auf dem fixierenden Auge möglich, eine befriedigende Fixation zu erreichen.
Summary
To avoid complications caused by vitreous bulging and eye movements in topical anesthesia or in insufficient retrobulbar anesthesia, a device was designed consisting of a diode array and a keyboard. The patient looks with the unoperated eye at the flashing diode. With the keyboard, the surgeon can change the signal over the entire array. The unoperated eye follows. Thus the operated eye is guided to the desired direction by conjugated eye movements. All muscles are in balance. Bell’s phenomenon is avoided. Topical anesthesia is supported. Insufficient retrobulbar anesthesia needs no second injection. Even with deep cataract on the fixating eye, proper fixation could be obtained.
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Literatur
Agrawal K, Saxena RC, Nath R, Saxena S (1993) Local anesthesia by peribulbar block for cataract extraction in an eye relief camp. Online J Curr Clin Trials. Doc No 40, Mar 19
Ali Melkkila TM, Virkkila M, Jyrkkio H (1992) Regional anesthesia for cataract surgery. Reg Anaesth 17 : 219–222
Ali Melkkila t, Virkkila M, Leino K, Palve H (1993) Regioal anesthesia for cataract surgery. Br J Ophthalmol 77 : 771–773
Apel A, Woodward R (1991) Single injection peribulbar local anesthesia. Aust NZJ Ophthalmol 19 : 149–153
Badescu S (1994) Perforation of the eyeball in retrobulbar anesthesia. Ophthalmologia 38:162–164
Benedetti S, Agostini A (1994) Periobulbar anesthesia in vitreoretinal surgery. Retina 14 :277–280
Bishara SA, Estrin I, Rand WJ (1990) Immediate contralateral amaurosis after retrobulbar aneshesia. Ann Ophthalmol 22 : 63–65
Burlew JA, Ferguson LS (1993) Patient responses to topical anesthesia for cataract surgery. Insight 18 : 24–28
Castillo A, Lopez-Abad C, Macias JM, Diaz D (1994) Respiratory arrest after 0,75% bupivacaine retrobulbar block. Ophthalmic Surg 25 : 628–629
Cohen SM, Sousa FJ, Kelly NE, Wendel RT (1992) Respiratory arrest and new retinal hemorrhages after retrobulbar anesthesia. Am J Ophthalmol 113 : 209–211
Davis DB, Mandel MR (1994) Efficacy and complication rate of 16224 consecutive peribulbar blocks. J Cataract Refract Surg 20 : 327–337
Demediuk OM, Dhaliwal RS, Papworth DP, Devenyi RG, Wong DT (1995) A comparison of peribulbar and retrobulbar anesthesia for vitreoretinal surgical procedures. Arch Ophthalmol 113 : 908–913
Dick B, Kohnen t, Hessemer V, Jacobi KW (1994) Systemic complications and side effects of retrobulbar anesthesia in risk patients. Klin Monatsbl Augenheilkd 205 : 19–26
Hamed LM, Mancuso A (1991) Inferior rectus muscle contracture syndrome afterr retrobulbar anesthesia. Ophthalmology 98 : 1506–1512
Hamilton SM, Elsas FJ, Dawson TL (1993) A cluster of patients with inferior rectus restriction following local anesthesia for cataract surgery. J Pediatr Ophthalmol Strabismus 30 :288–291
Hessemer V (1994) Peribulbar anesthesia versus retrobulbar anesthesia with facial nerve block. Klin Monatsbl Augenheilkd 204 : 75–89
Jain VK, Lawrence M (1994) Peribulbar versus retrobulbar anesthesia. Int Ophthalmol Clin 34 :33–42
Kempeneers A, Dralands L, Ceuppens J (1992) Hyaluronidase induced orbital pseudotumor as complication of retrobulbar anesthesia. Bull Soc Beige Ophthalmol 243 : 159–166
Kershner RM (1993) Topical anesthesia for small incision self sealing cataract surgery. J Cataract Refract Surg 19 : 290–292
Leonard PA, Klevering BJ, deKeizer RJ (1992) Complications of secondary surgical capsulotomy in pseudophacic and aphacic eyes. Ophthalmic Surg 23 : 330–335
Schipper I, Luthi M (1994) Diplopia after retrobulbar anesthesia in cataract surgery. Klin Monatsbl Augenheilkd 204 : 176–180
Shibata K, Inage K, Takayama T, Hara T (1993) Use of cold spray for relieving pain from local anesthetic injections in ocular surgery. J Ophthalmic Nurs Technol 12 : 23–30
Shriver PA, Sinha S, Galusha JH (1992) Prospective study of the effectivness of retrobulbar and peribulbar anesthesia for anterior segment surgery. J Cataract Refract Surg 18 : 162–165
Shuler JD (1993) Topical anesthesia in a patient with a history of retrobulbar hemorrhage. Arch Ophthalmol 111 : 733
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Frohn, A., Kremmer, S. (1997). Fixierlicht-Hilfe während der Kataraktoperation. In: Vörösmarthy, D., Duncker, G., Hartmann, C. (eds) 10. Kongreß der Deutschsprachigen Gesellschaft für Intraokularlinsen-Implantation und refraktive Chirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60558-1_53
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DOI: https://doi.org/10.1007/978-3-642-60558-1_53
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