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British Journal of Anaesthesia, 2001, Vol. 86, No. 4 473-476
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Editorial

Editorial IV

Local anaesthesia for eye surgery—no room for complacency

G.S. Thind and A.P. Rubin

A recent article by Vohra and colleagues1 reminds us that while regional anaesthesia for eye surgery is safe and reliable and complications are uncommon, there are a number of risk factors that predispose the globe to needle penetration during retrobulbar (RBA) and peribulbar (PBA) injections. The presence of a long eye, staphyloma or enophthalmos, the use of a faulty technique, a lack of appreciation of risk factors, an uncooperative patient and the use of an unnecessarily long needle are some of the contributory causes.2 Patients presenting with axial myopia have a 30 times greater risk of globe puncture compared with patients with normal axial length.2 A risk rate of one perforation for every 140 peribulbar blocks in eyes with an axial length greater than 26 mm has been calculated.2 Interestingly, an increase in axial length is associated with only a marginal increase in equatorial width.1 Vohra and colleagues1 have suggested . . . [Full Text of this Article]

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