• Retrobulbar anesthesia produces effective local anesthesia for ocular surgery, but significant complications have been reported with its use. To maintain its efficacy and to minimize the risks associated with the passage of a needle behind the eye, we have placed local anesthesia into sub-Tenon's space posteriorly using a blunt irrigating cannula in 100 patients undergoing vitreous or retinal procedures. Posterior Tenon's capsule is opened by blunt dissection, allowing the irrigating cannula to be passed into the posterior sub-Tenon's space for anesthetic injection. The technique was effective in 98 of 100 patients, and no morbidity was associated with its use.
Friedberg MA, Spellman FA, Pilkerton AR, Perraut LE, Stephens RF. An Alternative Technique of Local Anesthesia for Vitreoretinal Surgery. Arch Ophthalmol. 1991;109(11):1615–1616. doi:10.1001/archopht.1991.01080110153055