We appreciate the letter written by Arevalo and Yepez and thank them
for their constructive comments on our article.1
They point out that for selected patients, vitreoretinal surgery can be performed
with topical anesthesia, avoiding the risks of general, retrobulbar, or peribulbar
anesthesia. They report their experience with a series of 134 eyes undergoing
vitreoretinal surgery with topical anesthesia using 4% lidocaine hydrochloride
drops. We completely agree with Arevalo and Yepez in their concerns about
complications associated with retrobulbar or peribulbar anesthesia. We concur
that most vitreoretinal surgical procedures may be performed with local anesthesia,
and we also agree that "in selected patients for whom surgical time has been
calculated at no more than 2 hours," topical anesthesia may be an option.
Jonas JB, Budde WM, Dinkel M, Hemmerling TM. Temporary Retrobulbar Catheter for Local Anesthesia in Vitreoretinal Surgery. Arch Ophthalmol. 2001;119(6):924–925. doi:
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