Hyaluronidase (Wydase®) is a medical preparation of highly purified bovine testicular enzyme. The enzyme hydrolyzes hyaluronic acid, which usually limits diffusion by binding cells together. Thus, it is believed that hyaluronidase increases permeability and promotes the spread of local anesthetic. This accelerates the onset of akinesia, and also helps to reduce the increase in intraocular press...

To the Editor: 1The review article on ophthalmic regional anesthesia by Nouvellon et al. was engaging, particularly the cadaver photographs elucidating the spread of local anesthetic agent within the orbit as well as the links to supplemental digital content. The authors are to be commended for their comprehensive discourse. However, their assertions regarding akinesia, reproducibility, and reb...

BACKGROUND Recent advances in cataract surgery techniques have enabled these to be performed under less invasive local anaesthetic techniques. As a result, ophthalmic surgeons are increasingly prepared to give the local anaesthesia to the patient themselves without the need for the presence of an anaesthetist. METHODS A national postal survey was conducted in 2008, asking all consultant ophth...

The incidence of globe perforation following peribulbar anesthesia is rare, occurring in 0.006% of the cases in a recent series. The incidence of intraocular anesthetic injection is also rare; only 4 cases have been reported in the Englishlanguage literature. We report a case of an intraocular injection of a combination of bupivacaine hydrochloride and mepivacaine hydrochloride following globe ...

INTRODUCTION Locoregional anesthesia techniques are increasingly used for cataract surgery. From these techniques, peribulbar anesthesia has been very successful over the retrobulbar anesthesia seen its effectiveness and safety. However, peribulbar anesthesia is not without risk. CASE PRESENTATION A 70-year-old African man was scheduled for cataract surgery and lens implant for his right eye....

PURPOSE To assess the risk for and circumstances of serious complications during peribulbar and retrobulbar anesthesia. SETTING University eye departments, Freiburg and Würzburg, Germany, and Skopje, Macedonia. METHODS This retrospective analysis comprised patients who received secondary care for complications of inadvertent globe perforation during peribulbar or retrobulbar injections over...