A nice tip I learned at Fundacion in Santiago, Chile is that you can use a small gauge angiocath from the anesthesiologist's cart to tunnel into the inferonasal quadrant and not have to perform a conjunctival dissection.

Post ID: 6794 Link Reply Quote Report: Spam or Abuse

Dr. Kitchens, Several questions:

1. Is this your standard approach to all vitreoretinal cases, or are you using this simply for your microvitreoretinal procedures (23 and 25 gauge vitrectomies). I assume in these cases that you leave your conjunctival peritormy that you created for the anethestic apposed but not directly closed with suture at the conclusion of the case?

2. What about primary scleral buckles? Same anesthetic approach?

3. If you are using a true retrobulbar in any circumstance, do you carry out a standard transdermal approach or do you approach via the inferior fornix?

4. In all of your fornix-based approaches, do you find that you no longer have a patient with raccoon eyes (periorbital ecchymosis) following surgery?

5. Do you find patients can still "see" you operating during membrane peels with your approach or does the Wydase effect enough of an optic nerve block to preclude the patient's ability to see?

Great article!

Post ID: 7047 Link Reply Quote Report: Spam or Abuse