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Advances in phacoemulsification and self-sealing wound construction have made topical anesthesia an effective and reliable method of obtaining ocular anesthesia. It has many advantages over the traditional retrobulbar or peribulbar technique. I have performed more than 1800 cases of phacoemulsification and posterior chamber intraocular lens implantation through a 3 mm, self-sealing, corneal tunnel incision with topical anesthesia and the use of the Bloomberg SuperNumb Anesthetic Ring. This article presents the procedure. Results show the benefits of topical anesthesia and the anesthetic ring, including elimination of the risks of globe penetration, retrobulbar hemorrhage, respiratory depression, intradural or subarachnoid injection, ptosis, and diplopia, as well as instant return of vision.
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Bloomberg et al. (1995) studied this question.
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