General anaesthesia in ophthalmic surgery.

MANY ophthalmic operations can be performed under local analgesia and this technique is used with satisfaction in all parts of the world today; in fact many surgeons and consultant anaesthetists are satisfied that the best results are obtained by this method. On the other hand, general anaesthesia is used much more than formerly and in some centres it is used routinely for most operations, including removal of cataracts. There are, in addition, occasions when the future of the eye depends upon surgery which can only be performed under general anaesthesia; but if this is not skilfully administered a functionless eye may result from coughing and vomiting. Having watched the surgeons in this area make a slow but continuous change-over during about five years, I feel that it is opportune to review the value of general anaesthesia in ophthalmic surgery and to discuss ways to produce maximum benefit for patient and surgeon.