Indocyanine green enhanced diode laser photocoagulation of subretinal neovascular membranes.

EDrroR,-Stevens' has recently described local anaesthetic delivery into the sub-Tenon's space as an alternative to the conventional retrobulbar and peribulbar approaches for ophthalmic anaesthesia. Using a 50:50 mixture of lignocaine 2% and bupivacaine 0-5% without hyaluronidase he obtained effective anaesthesia in all of his 50 patients. However, 46% required an additional Van Lint facial block. I have now used the same method, employing a 21 gauge lacrimal cannula to deliver the anaesthetic in 24 patients undergoing cataract surgery. Lignocaine 2% (5 ml) and bupivacaine (Marcain) 0 5% (5 ml) were mixed with 1500 IU of hyaluronidase (Wyeth). Three ml were delivered in the manner Stevens describes. All patients had satisfactory analgesia and akinesia, while one patient only required an additional Van Lint facial block. The results obtained are shown in the Table.