ASSISTED LOCAL ANAESTHESIA FOR CATARACT SURGERY (ALACS)

This paper describes an assisted local anaesthetic technique which we have used almost exclusively for extracapsular cataract extraction and posterior chamber intraocular lens implant surgery over the last 12 months. This ALACS technique was developed from a combined neurolept-local anaesthetic into an assisted local anaesthetic suitable for day-stay cataract surgery. The technique combines the advantages of purely local (retrobulbar and facial) anaesthesia with the advantages usually inherent in a good general anaesthetic. Thus the patient is in a state of general quiescence and psychic indifference throughout the procedure. ALACS provides excellent and long-lasting akinesia and analgesia, with adequate proptosis of the eye which facilitates surgical access. ALACS is suitable for almost all adult cataract and implant surgery. Our results in 704 cases of ALACS are reviewed in terms of visual results and complications both ocular and anaesthetic; the results appear good and the complications minimal. The results of blood gas estimations done intraoperatively in a small number of patients are also presented, and suggest that the technique is systemically safe .