Abstract :
Aim: This study was designed to compare the effects of sub-Tenon’s, conventional peribulbar, and single injection medial canthus in anterior segment surgery. Methods: The study comprised 120 patients undergoing anterior segment eye surgeries patients were then divided randomly into three groups (40 patients in each group) according to the technique used: group 1: this group received sub-Tenon block divided into equal two subgroups; subgroup a: patients undergo sub-Tenon’s block; subgroup b: patients under go sub-Tenon block with 15 IU/ml hyaluronidase, group 2: patients received peribulbar block divided into 2 subgroups (a, b); subgroup a: undergo conventional peri-bulbar block; subgroup b: undergo conventional peribulbar block with 15 IUml hyaluronidase, group 3: patients received percutaneous single injection medial canthus divided into 2 subgroups (a, b); subgroup a: undergo percutaneous single injection medial canthus , subgroup b : undergo percutaneous single injection medial canthus with 15 IU/ml hyaluronidase. The results were assessed regarding: pain on injection, during surgery and postoperative, intra ocular pressure (IOP), degree of akinesia, conjunctival hemorrhage, need for facial nerve block, other complications and the results were analyzed statistically. Results: Pain scoring showed in group I a highly significant statistical difference in comparison with II and III especially on injection, there was high significant statistical difference between the 3 groups; the onset of globe akinesia was much faster in group I than in group II and III. In group I subgroup b there was no significant statistical difference between preinjection level of IOP, immediate after injection and 5 min after injection as no significant rise in IOP but not in group II, III significant statistical difference between preinjection levels of IOP, immediate after injection no significant statistical difference among the 3 groups as regards; facial nerve block, eyelid akinesia, supplementary injection, conjunctival oedema and conjunctival haemorrhage. Conclusion: Final result of this study confirms that sub-Tenon s and single medial canthus with hyaluronidase in terms of akinesia, rate of requirement of supplemental injection, pain scoring is superior to peribulbar anaesthesia and so can be good alternative to peribulbar anaesthesia.
