Anesthesia

There are numerous modes of anesthesia from which an eye surgeon can choose. Overall, there is not one type of anesthesia that is right for all cases. The best choice varies from surgeon to surgeon and from patient to patient. As cataract removal has become faster, safer, and less traumatic, the need for akinesia and anesthesia has declined significantly, and the use of general anesthesia or regional (i.e., retrobulbar or peribulbar) block has largely been replaced with other safer and equally effective means of local anesthesia including sub-Tenon’s block, subconjunctival, intracameral, and topical, the latter being the most used technique. These newer and less invasive methods have not only reduced the potential for catastrophic surgical complications but also increased the efficiency of cataract surgery (as there is probably no need for anesthetic team support) and hastened the process of visual rehabilitation. The goal of this chapter is to review the current choices for local ocular anesthesia in patients with glaucoma undergoing cataract surgery, helping to select the most appropriate type of anesthesia for each patient.