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To the Editor:—
Dr. Hagmeier is quite correct in stating that you have a quiet patient during surgery with general anesthesia. This is probably why—in a patient with paralysis agitans—it has been the standard procedure up to now, and the one that is most commonly taught. However, his report of 36 out of 157 patients in whom nausea, vomiting, and restlessness were observed is in marked contrast to the rare incidence of such symptoms occurring in patients operated under local anesthesia.It is quite obvious that with general anesthesia the incidence of ocular complications resulting from these symptoms would greatly exceed our "acceptable" norms (Stallard, H.B.: Eye Surgery, ed 3, Baltimore: Williams & Wilkins Company, p 83). This is probably why the vast majority of ophthalmologists throughout the world perform routine cataract extractions employing tranquilizers and antimetics. In reporting this case, I was merely suggesting one alternative to the present
Bellows JG. Method for Cataract Extraction in Parkinsonism. JAMA. 1965;192(2):174. doi:10.1001/jama.1965.03080150104042