Regional anesthesia and eye surgery.

THE vast majority of ophthalmic surgeries are performed under regional anesthesia only. However, its use is also described in association with general anesthesia for pediatric cases and for postoperative analgesia. Eye blocks have long been limited to retrobulbar anesthesia (RBA) as performed by surgeons. Surgical technique changes and research on improving patient safety during eye blocks has resulted in the development of alternative techniques, such as peribulbar anesthesia (PBA), followed by low-volume sub-Tenon block (STA) or topical anesthesia (TA). In this review, we present the general requirements necessary for an eye block and then briefly describe each technique, discussing their respective advantages and inconveniences. Although cataract surgery is the most frequent ophthalmic surgical procedure and a large number of articles we cite refer to studies concerning this procedure, implications to regional anesthesia are not limited to cataract surgery; much of the data we review can be extrapolated and reinterpreted for other ophthalmic applications.