Programm                 "Degeneration und Regeneration– Grundlagen, Diagnostik und Therapie"

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Retrobulbar Hemodynamics before and after Retrobulbar Anesthesia in Cataract Patients with and without Pseudoexfoliation Syndrome (PEX)

Huber K., Remky A., Arend O.
Aachen University, Dept. of Ophthalmology

Purpose: Patients with exfoliation syndrome (PEX) have an increased vascular risk and need an effective anesthesia because of a higher rate of intraoperative complications. In this study Color Doppler imaging was performed to investigate the effect of retrobulbar anesthesia on retrobulbar hemodynamics in eyes with and without PEX.
Method: In a prospective study 41 patients (age 73 ± 9; 22 f, 19 m) with cataract were included. In 14 (76 ± 10; 8 f, 6 m) of these patients PEX syndrome was present. Color Doppler imaging (Siemens Sonoline Sienna) was used before and directly after retrobulbar anesthesia and after cataract extraction to determine the peak systolic (PSV) and end-diastolic velocities (EDV) in the ophthalmic artery (OA), central retinal artery (CRA) and central retinal vein (CRV).
Results: Initially, there were no significant differences between eyes with and without PEX. After retrobulbar anesthesia both groups had a significant reduction of the PSV (OA by 36%, p <0.0001; CRA by 27%, p<0.0001). After surgery the flow velocities increased again (PSV: OA by 28%, p<0.0001; CRA by 20%, p<0.0001). In patients with PEX the reduction of the PSV after injection is more pronounced and the recovery is more reduced in the OA (p=0.007; ANOVA) and the CRA (p=0.04) compared to eyes without PEX. The other parameters showed no significant difference.

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