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Topical Anesthesia vs. Peribulbar or Retrobulbar Blocks in Cataract Surgery

Posted By Dr. Ari Weitzner On July 27, 2012 @ 5:18 am In Cataract | 3 Comments

I still do peribulbar (actually, the anesthesiologist does it for me), so when i enter the O.R., the eye sees and feels nothing and doesn’t move. I don’t have to nag the patient to look anywhere, like my residents do. Of course, with coumadin cases, I’ll do topical or sub-Tenon’s. Anyway, a meta-analysis by Dr. Zhu in Ophthalmology showed that topical is more painful than retrobulbar (about equal to peribulbar) – BUT, they excluded those topical cases using intracameral lidocaine, so in my opinion, the study is fatally flawed for practical purposes.


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