Intracameral Anesthesia

Abstract

SUBCONJUNCTIVAL, topical, and intracameral anesthesia have been popularized recently as new techniques for use in cataract surgery. These anesthetic routes have potential safety advantages over traditional techniques such as retrobulbar and peribulbar anesthesia.^1-8 Peribulbar and retrobulbar anesthesia can be complicated by globe perforation, retrobulbar hemorrhage, retinal vascular occlusion, extraocular muscle injury, optic nerve damage, brainstem anesthesia, and cardiac and respiratory arrest.^9-16 In contrast, use of topical anesthesia has minimal risks. The benefits of topical administration of anesthesia include immediate onset of action, short duration, and early return of visual acuity with no postoperative diplopia, ptosis, or ecchymosis.^17-19 However, there are shortcomings to topical administration of anesthesia, including inadequate blockade of sensory and motor nerves in the iris/ciliary body from incomplete absorption or dilution by tears. Therefore, patients may experience intolerance to the operating light microscope and discomfort from iris and lens manipulation during cataract surgery.²⁰