1M.D. Asistant, Haydarpasa Training and Research Hospital, Eye Clinic, Istanbul/TURKEY 2M.D. Associate Professor, Haydarpasa Training and Research Hospital, Eye Clinic, Istanbul/TURKEY 3M.D. Asistant Professor, Istanbul Bilim University, Faculty of Medicine, Department of Ophthalmology, Istanbul/TURKEY 4M.D. Haydarpasa Training and Research Hospital, Eye Clinic, Istanbul/TURKEY
Purpose: The comparison of the efficacy of topical, subconjunctival and subtenon anesthesia during intravitreal dexamethasone implant injection.
Materials and Methods: Thirty eyes of 30 patients with macular edema due to central retinal vein and retinal vein branch occlusion were
included in this study. Twelve patients received topical (0.5% propacaine), 10 patients received subconjunctival (lidocaine 20 mg/ml, epinephrine
0.0125 mg/ml) and 8 patients received subtenon (lidocaine 20 mg/ml, epinephrine 0.0125 mg/ml+bupivacaine) anesthesia during the
application of intravitreal dexamethasone implant. Patients’ pain during implant injection was evaluated with visual analog scale.
Results: Fourteeen patients were female and 16 patients were male. There was no significant difference between groups in terms of the patients’
age (p=0.304, p>0.05). Intravitreal injection of implant was successfully performed in all cases. The mean pain score after intravitreal injection
in topical group was found to be 5±1.67, while the score was 3.0±0.78 in subconjuntival and 0±0.35 in subtenon anesthesia group. Statistically
significant difference at an advanced level (p<0.01) was detected in pain scores between the three groups. There were no complications in the
topical group while subconjunctival hemorrhage occured in 3 eyes of subconjunctival group and 4 eyes in subtenon group (p=0.029, p<0.05).
Conclusion: Subtenon and subconjunctival anesthesia which provide deeper anesthesia can be considered as an alternative to topical anesthesia to
improve patient compliance and prevent rejection of subsequent injections in intravitreal dexamethasone implant injections by 22-gauge needle.