Local anaesthesia for ophthalmic surgery—new guidelines from the Royal College of Anaesthetists and the Royal College of Ophthalmologists

Severe adverse events associated with local anaesthesia in cataract surgery: 1 year national survey of practice and complications in the UK

“…The 2001 UK National Guideline on LA for ophthalmic surgery16 was cited in the 2010 UK Cataract guideline 17. The LA guideline was revised and updated in 2012, with an expanded section on ‘ complications and how to avoid them’ 18. This study confirms one of the main points of the 2012 LA Guideline: “Whatever their cause, serious systemic adverse events in association with ophthalmic surgery do sometimes occur, with all types of local anaesthetic techniques”, therefore “All ophthalmic units should have formal policy for dealing with medical emergencies should they occur.…”

“…This study confirms one of the main points of the 2012 LA Guideline: “Whatever their cause, serious systemic adverse events in association with ophthalmic surgery do sometimes occur, with all types of local anaesthetic techniques”, therefore “All ophthalmic units should have formal policy for dealing with medical emergencies should they occur. Appropriate backup from a cardiac arrest/Medical Emergency Team should always be available.”18…”

It is Just an Eye Case! Delayed Awakening After Retro-Bulbar Block

“…Early detection of these complications and their timely management are crucial. This case emphasizes the importance of presence of an anesthesiologist [13] with adequate monitoring to diagnose and immediately manage any complication. His or her presence adds to safety of patient even in a relatively low risk surgical procedure.…”

Painless Indirect Argon Laser in High Risk Proliferative Diabetic Retinopathy

“…Argon green laser and more recently the 532-nm-wavelength PAttern SCan Laser (PASCAL photocoagulator) are the most common lasers in clinics for PRP worldwide [6][7][8][9] Complete PRP can be precluded by impaired visibility of the fundus, restriction in patientsʼ mobility or compliance. Painful laser treatment can be a major issue when dense PRP is required [10,11]. In incomplete PRP, danger of developing further proliferative new vessels remains high despite the realized treatment [12,13].…”

“…This allows application of a high number of burns (mean of 1598 ± 558.5 impacts per eye) in a single session in the OR. Pain related to laser treatment is a wellknown factor for incomplete PRP [11]. Reducing pain during treatment is one of the major element favoring Pascal pattern scan laser in clinical practice [25].…”