Short-acting peribulbar anesthesia with 2-chloroprocaine

A 64-year-old monocular man had uneventful penetrating keratoplasty in his seeing eye for aphakic bullous keratopathy and counting fingers visual acuity. One year later, standard slitlamp suture removal under topical anesthesia was not possible because of sensory nystagmus. In addition, the patient could not have general anesthesia as a consequence of severe coronary artery disease. He requested that the procedure be done with a short-acting local anesthetic agent so a patch would not be necessary. He successfully had the procedure using a peribulbar injection of 2-chloroprocaine (Nesacaine-MPF); vision and ocular motility returned 15 minutes after the surgery was completed. At subsequent examinations, the visual acuity was 20/200 and the graft was clear despite a congenital macular scar.