Augmentation of local anesthesia during retinal detachment surgery.

Because the effect of local anesthesia from a retrobulbar injection diminishes with time, local anesthesia during prolonged retinal surgery may be difficult. A simple, safe, and effective technique for administration of supplemental intraoperative local anesthesia during retinal detachment surgery is described. After a limbal peritomy is performed and the quadrants are dissected bluntly, a 19-guage irrigating cannula is passed posterior to the globe to irrigate the recti muscles and the retrobulbar space with 4% lidocaine hydrochloride. Using this technique, even prolonged vitreoretinal surgery can be performed using local anesthesia with minimal patient discomfort.