Effect of Addition different dosage hyaluronidase to peribulbar anesthesia mixture for lowering intraocular pressure

Objective To observe the effectiveness of addition different dosage hyaluronidase to peribulbar anesthesia mixture for lowering intraocular pressure and find the right dosage of hyaluronidase in peribulbar anesthesia.Methods A case-control prospectively study.The clinical data from 120 cases (120 eyes) undergone intraocular surgery were analyzed.The cases were divided into 4 groups randomly and there were 30 cases (30 eyes) every group.Group 1 was peribulbar anesthesia with 3ml mixed liquor of lidocaine and bupivacaine.Group 2,Group 3 and Group 4 were peribulbar anesthesia with 3ml mixed liquor of lidocaine and bupivacaine which addition hyaluronidase 75u,150u,300u,respectively.The intraocular pressure was observed,the corneal endothelial cells were counted,and electroretinogram before and after perform peribulbar anesthesia were examined.Results The intraocular pressure were increased post-peribulbar anesthesia than pre-peribulbar anesthesia in group 1 (15.64±1.71 versus 18.09±2.95mmHg,P ＜0.05).It had significant differences change between group 1 post-peribulbar anesthesia and pre-peribulbar anesthesia.The intraocular pressure were decreased post-peribulbar anesthesia than pre-peribulbar anesthesia in group 2,group 3 and group 4.(16.20±1.71 versus 14.97±1.00 mmHg,P ＜0.05; 16.32±1.69 versus 14.66±1.51 rnmHg,P ＜ 0.05; 16.52±1.76 versus 14.63±2.03mmHg,P ＜0.05),the changes had significant differences.No significant differences were found in intraocular pressure value among group 2,group 3 and group 4 post-peribulbar anesthesia (14.79±1.00 versus 14.66±1.51 versus 14.63±2.03mmHg; P ＞0.05).The changes of electroretinogram and counting of the corneal endothelial cells had no significantly different (P ＞0.05).Conclusions Hyaluronidase can effectively decrease intraocular pressure after peribulbar anesthesia.No severe adverse effect is found after addition hyaluronidase in peribulbar anesthesia.But its effects dose not increase with increasing of the dosage. Key words: Hyaluronidase;  Dosage;  Peribulbar anesthesia;  Intraocular pressure