Methods of inducing profound local anesthesia and hypotony will be presented which improve the safety of cataract surgery.
The retrobulbar injection was described by Pooley1in 1914. Elschnig2,3 (1925) and Izaca4 (1946) found that retrobulbar anesthesia lowered the intraocular tension. Gifford5 (1949) demonstrated that the retrobulbar injection of procaine (Novocain) hydrochloride alone caused a fall of intraocular tension to about two-thirds of its former level, which he believed was due to paralysis of the extraocular muscles. There is apparently a base tension in the eye to which is added a pressure from the tonus of the extraocular muscles. A complete block of all action of the muscles lowers the intraocular tension.
I have confirmed this in more than 100 cases. I find that the fall in tension is not uniform but is less in glaucoma and varies with the degree of anesthesia that is achieved.
GARTNER S. Methods of Inducing Anesthesia and Hypotony for Cataract Surgery. AMA Arch Ophthalmol. 1959;61(1):50-54. doi:10.1001/archopht.1959.00940090052007