[Subconjunctival or general anaesthesia in trabeculectomy--a retrospective analysis of the bleeding risk from a glaucoma surgeon's point of view].

INTRODUCTION

The aim of this study was to compare the intraoperative and early postoperative outcome of trabeculectomy with mitomycin C in glaucoma patients undergoing general anaesthesia compared to those undergoing subconjunctival anaesthesia.

METHODS

The perioperative results of consecutive glaucoma patients receiving a trabeculectomy with mitomycin C either under general anaesthesia (group 1, n = 60) or in subconjunctival anaesthesia (group 2, n = 60) were analysed in a retrospective study. All surgical procedures were performed by one surgeon and only one eye of each patient with no history of previous conjunctival surgery was included in the study.

RESULTS

No significant peri- and postoperative differences concerning period of hospitalisation, intraocular pressure, filtration-bleb bleedings, hyphaema, frequency of laser suture lysis, hypotony, chorioidal detachment or revision surgery could be shown between the two groups. Considering all patients together, there was a significant correlation between the occurrence of postoperative filtering bleb bleedings and the absolute number of topical antiglaucomatous substances used prior to surgery.

CONCLUSIONS

The perioperative risk profile of penetrating glaucoma surgery with subconjunctival anaesthesia seems to be similar to that of procedures under general anaesthesia. For prevention of postoperative filtering bleb bleedings, the administration of topical antiglaucomatous drugs should be stopped before surgery.