Effect of sub-Tenon's and peribulbar anesthesia on intraocular pressure and ocular pulse amplitude

Purpose: To compare the effect of peribulbar and sub-Tenon's anesthesia on intraocular pressure (IOP) and ocular pulse amplitude (OPA) in the injected eye and the fellow noninjected (control) eye. Setting. Tel Aviv Medical Center, Tel Aviv, Israel. Methods. This prospective study measured IOP and OPA at baseline and 1 and 10 minutes after administration of lidocaine anesthesia in 40 consecutive a dult patients having elective cataract surgery. Results: The IOP remained stable throughout the study with both modes of an esthesia. One minute after injection of the anesthetic agent, the OPA was s ignificantly decreased in the injected eyes in both the sub-Tenon's (24%; P < .05) and peribular (25%; P < .05) groups. The decrease in the OPA in the sub-Tenon's group (14%; P < .05) was detectable after 10 minutes in the co ntrol eyes. In the peribulbar anesthesia group, the OPA in the control eyes increased significantly (9%; P < .05) 1 minute after injection. Conclusions. The OPA in the eyes In which lidocaine was Injected decreased significantly in both the sub-Tenon's and peribulbar groups. These findings have implications for the management of patients whose ocular circulation may be compromised. J Cataract. Refract Surg 2001; 27:1221-1226 (C) 2001 AS CRS and ESCRS.