Reduction of subconjunctival hemorrhage with sub-Tenon's anesthesia.

摘要

Adequate anesthesia is a cornerstone of cataract surgery. Several techniques have been used, including retrobulbar anesthesia, peribulbar anesthesia, sub-Tenon's anesthesia, intracameral anesthesia, and topical anesthesia.1 The first 3 techniques have the advantage of achieving akinesia over the other 2 techniques.1 Of the 3 techniques, sub-Tenon's anesthesia is gaining popularity because of the ease of administration and the reduced incidence of globe perforation.2 However, a disadvantage of the technique is subconjunctival hemorrhage during the conjunctival incision. This is often alarming to patients and causes dissatisfaction with the surgery. Several methods may be used to reduce this complication: the use of phenylephrine to constrict the blood vessels and the avoidance of blood vessels by carrying out the conjunctival incision under the microscope. However, neither method is foolproof. The constricted blood vessels may still bleed when cut, and microscopic visualization may not avoid vessels that are too small to visualize.