Controlled retrobulbar anesthesia for ECCE and IOL implantation

A method of controlled retrobulbar anesthesia was used in 20 patients undergoing extracapsular cataract extraction with intraocular lens implantation. The method includes: leaving the pupil undilated before anesthesia; applying topical anesthetic to the conjunctiva; injecting about 0.25 ml of anesthesia through the non-sensitive conjunctiva into the muscle cone, then waiting until the pupil becomes dilated before injecting an additional 1.5 ml; injecting 0.25 ml anesthesia under the conjunctiva and into the tendon of the superior rectus muscle; and applying short-acting mydriatics after the injection. This method is almost painless and does not result in increased intraocular pressure after injection. Massage or compression to soften the eye is not required, and there is excellent anesthesia and akinesia.