AS AN ocular surgeon and teacher for more than twenty years, one naturally forms certain judgments as to surgical methods and procedures. These are offered herewith in the hope that they may be of benefit to others. Although it is realized that many may be an old story, others may be of interest.
No excuse exists for poor anesthesia. A fearful and uncooperative patient makes for a poor surgical performance.Preoperative sedation is indicated for all patients. Morphine should not be given before intraocular operations, since it may lead to vomiting. However, its use is quite satisfactory for extraocular surgical procedures.Cocaine hydrochloride is probably the best of the local anesthetics for instillation. The lids should be kept closed, since cocaine disturbs the corneal epithelium to a less extent under this condition. Also, cocaine should not be instilled for more than ten or twelve minutes ; longer periods tend to
O'BRIEN CS. OCULAR SURGERY: Random Observations. Arch Ophthalmol. 1947;37(1):1–7. doi:10.1001/archopht.1947.00890220004001
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