• Because the effect of local anesthesia from a retrobulbar injection diminishes with time, local anesthesia during prolonged retinal surgery may be difficult. A simple, safe, and effective technique for administration of supplemental intraoperative local anesthesia during retinal detachment surgery is described. After a limbal peritomy is performed and the quadrants are dissected bluntly, a 19-gauge irrigating cannula is passed posterior to the globe to irrigate the recti muscles and the retrobulbar space with 4% lidocaine hydrochloride. Using this technique, even prolonged vitreoretinal surgery can be performed using local anesthesia with minimal patient discomfort.
Mein CE, Flynn HW. Augmentation of Local Anesthesia During Retinal Detachment Surgery. Arch Ophthalmol. 1989;107(7):1084. doi:10.1001/archopht.1989.01070020146049