A comparison of retrobulbar and periocular anesthesia for cataract surgery
J. L. Weiss and C. B. Deichman
Department of Ophthalmology, Mary Imogene Bassett Hospital, Cooperstown, NY.
Complications of retrobulbar anesthesia are rare but significant.
Periocular anesthesia has been advocated as an alternative to retrobulbar
injections. In a prospective, randomized, masked study of 79 consecutive
cataract extractions with intraocular lens implantations, 40 patients
received retrobulbar injections and 39 patients received periocular
injections. In every instance, the volume of the injection was 5 mL. No
significant difference in surgeon's assessment of akinesia and anesthesia
was found. Supplemental anesthesia was required in eight (21%) of the
patients who received retrobulbar injections and in 11 (28%) of the
patients who received periocular injections. A significant increase in
chemosis was found with periocular injections. There was one complication
with retrobulbar anesthesia and none with periocular anesthesia. No
significant difference in patient assessment of comfort was found. The
efficacy of periocular anesthesia appears to be comparable to that of
retrobulbar anesthesia.
