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ESRA19-0370 Preliminary results of a randomized, prospective and non-inferiority study comparing standard vs. lacrimal dilator facilitated sub-tenon’s block
  1. OY Çok1,
  2. M Coban-Karatas2 and
  3. CM Kumar3
  1. 1Baskent University, Adana Dr Turgut Noyan Education and Research Center, Anaesthesiology, Adana, Turkey
  2. 2Baskent University, Adana Dr Turgut Noyan Education and Research Center, Ophthalmology, Adana, Turkey
  3. 3Khoo Teck Puat Hospital, Anaesthesia, Singapore


Background and aims Sub-Tenon’s block (STB) is increasingly used for cataract surgery to reduce risk of complications related to needle blocks.1 The technique involves making a conjunctival incision with blunt forceps and scissors followed by insertion of a blunt cannula into the sub-Tenon’s space. Recently, a sub-Tenon’s technique has been described in which a small aperture in conjunctiva is made with a lacrimal dilator.2 This technique accelerates block performance, minimize local trauma, improves surgical field and avoids surgical incision of conjunctiva.3 We report preliminary results of a randomized, prospective, non-inferiority study comparing standard vs. lacrimal dilator-facilitated sub-Tenon’s block.

Methods Patients undergoing elective cataract surgery were enrolled into two groups; standard sub-Tenon’s dissected with Westcott scissors (WS) or entry portal obtained with a lacrimal dilator (LD) A 19G, 2.5 cm long sub-Tenon’s curved cannula was used in both groups to deliver 3 mL, 2% lidocaine. No sedation was used. Data collection included demography, procedure duration, chemosis, intraoperative analgesia (Numeric Rating Scale 1–10), akinesia (4-primary gazes) and the quadrant/s of subconjunctival haemorrhage on the first postoperative day.

Results Patients in both groups were comparable for demographic data, procedure duration, analgesia and akinesia (p>0.05). The incidence of chemosis and subconjunctival hemorrhage were significantly lower in Group LD (n=15) in comparison to Group WS (n=26) (p=0.001 and p<0.001, respectively).

Abstract ESRA19-0370 Figure 1

Lacrimal dilator-facilitated entry during STB.

Abstract ESRA19-0370 Figure 2

Subconjunctival haemorrhage following STB in the same patient; with lacrimal dilator in the right eye(a) and with scissors in the left eye(b).

Conclusions Incisionless sub-Tenon’s block with lacrimal dilator is a practical and effective alternative to standard technique with reduced chemosis and subconjunctival hemorrhage.

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