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Ropivacaine for Topical Anesthesia in Pterygium Surgery With Fibrin Glue for Conjunctival Autograft

Caccavale, Antonio MD, FEBO; Romanazzi, Filippo MD; Imparato, Manuela MD; Negri, Angelo MD; Porta, Alessandro MD; Ferentini, Fabio MD

doi: 10.1097/ICO.0b013e3181ba7061
Clinical Science

Purpose: To evaluate efficacy of ropivacaine 1% for topical anesthesia in pterygium surgery with conjunctival autograft using fibrin glue for attaching the graft to the bare sclera.

Methods: Thirty-seven patients affected by primary pterygium underwent surgical excision under topical anesthesia with ropivacaine 1%. We performed a surgical approach with dissection of the pterygium, scraping of corneal bed with a motorized burr, meticulous excision of underlying Tenon's capsule, preparation of a free autologous conjunctival graft in the superior sector, excision of the graft, and position of the same to cover the scleral bed exposed in the nasal area with respect to limbus and stromal orientation fixing the graft with fibrin glue.

Results: It was possible to perform all the procedures without any supplemental anesthesia and sedation. The pain reported by patients, recorded by a 0 to 10 scale, was low during the entire surgery. The technique with conjunctival autograft using a fibrin sealant allowed for short operative times and good aesthetic and functional results.

Conclusions: Topical anesthesia with ropivacaine is safe and effective in pterygium surgery. The Long-lasting anesthesia with this agent permitted performing our surgical procedures with autograft conjunctival graft and fibrin glue to attach the flap with low pain perceived by our patients, low surgical invasivity, and short duration of surgery.

From the Department of Ophthalmology, Neuro-ophthalmology and Ocular Immunology Service, Hospital “C. Cantù,” Abbiategrasso, Milan, Italy.

Received for publication March 26, 2009; revision received July 17, 2009; accepted July 31, 2009.

The authors state that they have no financial interest in any of the products or devices mentioned in the article.

Reprints: Antonio Caccavale, MD, Department of Ophthalmology, Neuro-ophthalmology and Ocular Immunology Service, Hospital “C. Cantù,” Abbiategrasso, Milan, Italy (e-mail: neureye@katamail.com).

© 2010 Lippincott Williams & Wilkins, Inc.