97th DOG Annual Meeting 1999



D. T. Pham, A Weller, H Häberle (Berlin)

Introduction: Intracameral anesthesia minimizes the complications of peribulbar and retrobulbar anesthesia. The intact ocular motility could be a risk of capsular lesions during the cataract operation.

Method: A prospective study of consecutive operations by one surgeon. The operation was divided into three steps: Phacoemulsification, Cortexaspiration and IOL-Implantation. The operations were described with two degrees of difficulty: "normal" (small nucleus, wide pupil, deep anterior chamber), "difficult" (badly transparent cornea, large brownish nucleus, narrow pupil, flat or very deep anterior chamber, axial length < 22 or > 26 mm). The sensations were classified in four levels: "none", "burning", "dull", "pain".

Results: 2000 cataract operations were recorded from 09/1997 to 02/1999. In 17 cases capsular rupture occured (0,85 %). 15 cases were with high difficulty: 3 x subluxated lenses and 3 x mature and hypermature lenses. 6 operations were performed at a narrow pupil. 11 times an anterior vitrectomy was performed, once a pp vitrectomy was necessary after having applicated retrobulbar anesthesia in addition. An AC lens was used in one eye. In 16 patients a PC lens was implanted: once with rhexisfixation and 15 times with sulcus implantation. All patients could be operated comfortably with excep- tion of one patient who noted pain.

Conclusion: The capsular rupture occured in complicated situations, which are primarily due to anatomic conditions of the eyes like narrow pupils, mature and subluxated lenses. The incidence of the operative complications is comparable to other anesthetic procedures. The intracameral anesthesia is consequently effective and safe.

Krankenhaus Neukölln, Abt. für Augenheilkunde, Rudower Str. 48, 12313 Berlin