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Abstract

We appreciate the correspondence from Yolcu and associates and are pleased to respond to their concerns about the effects of sub-Tenon local anesthetic on the results of our recently published study. 1 Siegfried CJ, Shui YB, Bai F, Beebe DC. Central corneal thickness correlates with oxygen levels in the human anterior chamber angle. Am J Ophthalmol 2015;159(3):457–462. Google Scholar As noted in our Methods section, we performed an injection of 3 mL of 2% lidocaine and 0.375% bupivacaine in a 50:50 solution, using a blunt cannula through a small incision in the inferior fornix. In fact, not all patients received the full amount of anesthetic at the time of the measurement prior to initiation of the surgical procedure, as many received additional anesthetic in the superior conjunctiva in cases of glaucoma surgery. We did not record the precise volume/location received by each patient. Perhaps we should have stated “up to 3 mL” of anesthetic injection to better describe our technique. As they correctly noted, retrobulbar local anesthetic, especially with added epinephrine, significantly alters ocular hemodynamics. 2 Huber K.K. Remky A. Colour Doppler imaging before and after retrobulbar anaesthesia in patients undergoing cataract surgery. Graefes Arch Clin Exp Ophthalmol. 2005; 243: 1141-1146 Crossref PubMed Scopus (9) Google Scholar However, our technique of sub-Tenon/subconjunctival anesthetic injection without epinephrine has not been shown to have a significant effect on ocular hemodynamics. 3 Huber K.K. Remky A. Effect of retrobulbar versus subconjunctival anaesthesia on retrobulbar haemodynamics. Br J Ophthalmol. 2005; : 719-723 Crossref PubMed Scopus (27) Google Scholar We have also documented pO2 measurements on patients receiving only topical anesthetic of lidocaine gel 1% with no differences at any intraocular location (unpublished data). Central Corneal Thickness Correlates With Oxygen Levels in the Human Anterior Chamber AngleAmerican Journal of OphthalmologyVol. 159Issue 3PreviewWe read with interest the article by Siegfried and associates1 describing the measurement of oxygen distribution in different regions of the anterior segment of the eye. Full-Text PDF