Methods of inducing local anesthesia and hypotony for cataract surgery were presented in a previous report.1 Further experience has dictated the need for additions to that technique to obtain a soft and immobile eye that will permit cataract extraction to be as easy as on a cadaver. The chances of vitreous loss are slight if there is no power in the lids or extraocular muscles to express the vitreous.
Some surgeons, who have been impressed by their complications in operating under local anesthesia, have turned to general anesthesia, which unfortunately has a significant morbidity and mortality.2 Some add curare with even greater risks. Uncontrollable coughing, vomiting, and straining with general anesthesia add unnecessary risks. General anesthesia should rarely be necessary since it is possible to obtain excellent local anesthesia.
An advance in local anesthesia was made by the addition of digital pressure on the eye following the injection
GARTNER S. Methods of Inducing Complete Local Anesthesia for Cataract Surgery. Arch Ophthalmol. 1961;66(1):76-79. doi:10.1001/archopht.1961.00960010078017