Sub-Tenon's anesthesia: an update

Abstract

Sub-Tenon’s block has become the most common technique of orbital regional anesthesia in many centers. It provides effective anesthesia to the orbit with a lower incidence of sight-threatening complications than sharp needle techniques. This article will discuss the relevant anatomy, finer points of sub-Tenon’s block technique, and the evidence supporting its safety.

Sub‐Tenon's injection in equine cadaver eyes: MRI visualization of anesthetic fluid distribution and comparison of two different volumes

“…A good understanding of the anatomical landmarks and attention to the appropriate technique is essential to achieve the acquired akinesia, mydriasis, and desensitization of cornea, iris, and sclera (Fig. ) …”

Evaluation of Therapeutic Tissue Crosslinking (TXL) for Myopia Using Second Harmonic Generation Signal Microscopy in Rabbit Sclera

“…This technique is well known as a useful method of inducing ocular anesthesia. 7–9 Wollensak 10 has described previously the use of a sT injection using glyceraldehyde (a chemical crosslinking agent similar in concept to the FARs described in this study) to stiffen the rabbit sclera 10 and genipin has been shown to limit axial length in FD guinea pigs. 11,12 These investigators have demonstrated an advantage of using a soluble chemical agent over the photochemical (CXL) technique.…”

Pharmacologic Alternatives to Riboflavin Photochemical Corneal Cross-Linking: A Comparison Study of Cell Toxicity Thresholds

“…The extent of the sub-Tenon's space, as defined by Tenon's capsule (or orbital fascia), limits the area of cross-linking to this space, favoring uniform distribution across the posterior sclera, which is the location of desired effect. 14 Thus, in lieu of such concerns and potential benefits, the development of an alternative cross-linking approach that could avoid the use of UV-A light, and avoid epithelial removal (for the cornea), is less cytotoxic and could provide crosslinking to the posterior sclera without requiring a light source, and could be of significant interest to the field of ophthalmic therapeutics. This has prompted a search for candidate chemical cross-linking agents that could be used for therapeutic stabilization of either the cornea and/or sclera.…”