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Case Report:
Acupuncture Anesthesia
For Ophthalmic Surgery
Jennifer C. Choi, MD
Objective
To describe the use of acupuncture to achieve anesthesia during ophthalmic
surgery.
Problem
A patient undergoing corrective eye surgery.
History of Present Illness
A 49-year-old woman underwent corrective surgery to the right eye for
right medial rectus re-recession and right lateral rectus advancement/recession
in 1997. She had previous successful corrective surgery for exotropia
at 9-years-old. The patient's right eye started to turn in and became
esotropic; she had amblyopia on the right.
Treatment
The patient received acupuncture anesthesia after a topical eyedrop
of oxymetazoline hydrochloride, and Tetacaine was applied. Chuancho,
Taiyang, and Hoku points were needled and twirled until Qi was obtained,
and then connected to an electrical stimulator (AKC Akupunctuer Model
71-6) with a frequency of 4 Hz. Auricular acupuncture was performed
on the Shen Men point and connected to an electric stimulator.
Acupuncture stimulation was started 30 minutes before the surgery, with
maximum tolerance level. Muscle contraction of ocularis oculi, temporalis,
and the first dorsal interosseus was observed. An intravenous line was
kept open with 5% dextrose water.
Surgical Procedure
An incision was made in the conjunction fornix and carried down to Tenon's
capsule to bare sclera. The subconjunctival space from the previous
operation was dissected. Rectus muscles were identified using small
and large hooks. Insertion of muscles was detached and re-attached in
an adjustable recession. The conjunctiva was self-closed.
Outcome
Total surgical time was 1 hour; lateral rectus recession required longer
since there was more scar tissue formation from the previous surgery.
Suture adjustment could be performed on the operating table since the
patient had full kinesia and normal optic nerve function, not being
under chemical anesthesia.
AUTHOR INFORMATION
Dr Jennifer C. Choi is Board-certified in Physical Medicine and Rehabilitation,
and incorporates Medical Acupuncture in a pain management setting. Dr
Choi is Director of the Medical Acupuncture Department at Southside
Hospital, Bay Shore, New York, and is President of the New York Acupuncture
Society for Physicians and Dentists.
Jennifer C. Choi, MD, PC
2375 New York Ave
Huntington Station, NY 11746
Phone: 631-549-8120 • Fax: 631-549-7019
and
45 Terry Rd
Smithtown, NY 11787
Phone: 631-360-7380 • Fax: 631-360-3095
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