[Local anesthesia in ophthalmologic surgery]

Abstract

Operations of the anterior segment of the eye are dominant in ophthalmic surgery. It is a lesser known fact that these are the most common elective surgical procedures of all. There has been a dramatic change of anaesthetic practice for ophthalmic surgery over the last twelve years. LA is the anaesthetic of choice nowadays unless contraindicated. These changes were brought about due to the fact that anaesthetists initially became involved and then took over the performance of LA in ophthalmology. Peribulbar technique was introduced in 1986 as a safer alternative to retrobulbar anaesthesia. The needle tip is placed outside the muscle cone (in the peribulbar space). Adequate eyelid blockade and good hypotony of the eye is achieved. Perforation of the eyebulb is extremely rare complication. Sub-Tenon's anaesthesia is a new method of direct infiltration of local anaesthetic into sub-Tenon's space using a blunt cannula. Sub Tenon blocks avoid blind sharp needle penetration into space of the orbit. Although still a relatively new technique, sub-Tenon's anaesthesia is becoming increasingly popular. Day care intraocular surgery under local anaesthetic is the option of choice. Patients are admitted, operated on and discharged within few hours.