Fortschritte der Ophthalmologie : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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Fortschr Ophthalmol · Jan 1989
[Intraocular pressure and ocular hemodynamics following oculopression with and without added retrobulbar anesthesia].
Two series of experiments were performed prior to cataract surgery. In series 1, in 30 patients oculopression was performed for 15 min (30, 40 or 50 mmHg). Directly after oculopression the intraocular pressure (Pio) was found to be reduced by an average of 10.7 mmHg. ⋯ The changes observed in series 1 and 2 did not depend on the amount of oculopression. We conclude that a reduction in Pio after oculopression has a beneficial effect on the ocular circulation (increased perfusion pressures), whereas retrobulbar anesthesia has an inhibitory effect (reduction of perfusion pressures and PVoc). The hemodynamic effects of oculopression are largely suppressed by additional retrobulbar anesthesia.
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Fortschr Ophthalmol · Jan 1989
[Changes in uveal and retinal hemodynamics caused by retrobulbar anesthesia using various injection volumes].
In 20 patients, retrobulbar injections of 2 or 5 ml local anesthetic (bupivacaine-lidocaine mixture with hyaluronidase) were given preoperatively. Directly after the 5-ml injection, the systolic retinal and ciliary perfusion pressures (measured by means of oculo-oscillo-dynamography according to Ulrich) were reduced by an average of 5.6 mmHg (p less than 0.001) in comparison with the untreated fellow eyes. The ocular pulsation volume (PVoc) was reduced by 39%. ⋯ However, there was no significant change in perfusion pressures or Pio after the 2-ml injection. The findings observed during retrobulbar anesthesia may be interpreted as an inhibitory effect on ocular hemodynamics, which increases at higher injection volumes. This effect cannot be accounted for by adrenaline--which was not employed--and can at best only partially be accounted for by the changes in Pio.