Elizabeth A. Bradley, M.D.

After surgery to remove the eye, either by enucleation or evisceration, patients have variable levels of pain for several postoperative days. Some patients have almost no discomfort while others require significant amounts of oral narcotics and report pain of 10 out of 10 on a numerical rating scale. The current operative standard is to infiltrate the eye socket with 0.5% bupivacaine during surgery leading to several hours of postoperative analgesia. In 2011, Pacira Pharmaceuticals released a bupivacaine liposomal injectable suspension (Exparel, 1.3%) which offers sustained release of bupivacaine giving postoperative pain control for up to 72 hours. This medication has been used in numerous surgeries including inguinal hernia repair, hemorrhoidectomy, bunionectomy, breast reconstruction, and orthopedic surgery, and the literature reports improved pain control, decreased use of oral opioids, and increased patient satisfaction. There are no reports of the use of Exparel in the ophthalmic literature. The investigators propose a randomized, controlled trial to compare the postoperative pain control offered by sustained release bupivacaine to that offered by standard plain bupivacaine after enucleation or evisceration.

The purpose of this study is to see if photographs of the eyes are enough to identify a person who is not a public figure.

The goal of this study is to update the incidence of perioperative vision loss from ischemic optic neuropathy, retinal vein or artery occlusion, and cortical blindness from all non-ocular general anesthesia surgery, including robotic surgery, that has been performed at Mayo Clinic from 2003-2012. The study will also aim to determine the visual acuity outcomes following perioperative vision loss.