Background: Transconjunctival peribulbar anesthesia is reported to permit better identification of the bulbar limits because of a better view into the fornix; it is also said to be less painful compared to transcutaneous peribulbar anesthesia. The aim of our study was to compare the two injection techniques.
Patients and methods: This study comprised 46 patients undergoing eye operations under local anesthesia. They were allocated randomly in a prospective and simple masked study. Twenty-three patients received transconjunctival injections and 23 patients transcutaneous peribulbar injections. Before injection, all patients received Oxybuprocain eyedrops for anesthesia of the conjunctiva. In all cases no separate injections for lid akinesia were performed. Before and 20 min after the injection, the following parameters were assessed: pain score (visual analog scale), frequency of conjunctival chemosis and the necessity for supplemental anesthesia. For identification of the bulbar limits we checked if it was possible to see the caudal and the cranial fornix.
Results: The transconjunctival injection was significantly (P = 0.05) more painful (5.6 +/- 2.4) than the transcutaneous injection (4.2 +/- 2.4). Among the patients with transconjunctival injection, in 66.6% the cranial fornix could not or was only poorly seen.
Conclusions: Transconjunctival peribulbar anesthesia appears not to be more advantageous than transcutaneous peribulbar anesthesia.