Dr. Greenbaum is a World Expert on Cataract Surgery Anesthesia

Prior to Dr. Greenbaum’s publishing of his work in the American Journal of Ophthalmology, eye surgeons routinely used needles of various lengths and diameters to deliver anesthesia around the eye prior to cataract, retina, cornea, and glaucoma surgery. This practice still persists today, however to a much lesser extent. Many surgeons adopted Dr. Greenbaum’s Parabulbar or Anterior subTenons technique worldwide. Other’s adopted Dr. Richard Fischman’s topical (eye drop) technique. However, while both techniques completely eliminated the risk of needles (Dr. Greenbaum employed a soft cannula) only Parabulbar anesthesia provided complete anesthesia- the eye movement is decreased, the patient does not feel the surgery, and the light of the very bright operating microscope cannot be seen. This last advantage provides additional patient comfort in comparison to topical anesthesia. To supplement patient discomfort from the halogen microscope bulb, most anesthesiologists use more intravenous anesthesia in surgery. This is done under pure topical anesthesia and many eye surgeons inject anesthesia anesthesia into the eye (intracameral lidocaine). These steps add risk and are not required with Parabulbar anesthesia.

Dr. Greenbaum has trained other eye surgeons and anesthesiologists in his technique and feels he has saved thousands of eyes from unnecessary needle derived risk. The most common question Dr. Greenbaum hears at the conclusion of his surgery comes from patients asked to open and close their eyes for the administration of antibiotic ointment- “Doc is my open or closed?" This proves that the patient did not see the bright microscope bulb and the surgical instruments. Of course, the anesthetic wears off in the minutes following the procedure so that the patient can enjoy restored vision rapidly, but the need for prolonged recovery from additional intravenous sedation is also eliminated. There have been no reported adverse effects reported from Anterior subTenons-Parabulbar anesthesia in the world’s literature.

Dr. Greenbaum wrote the chapter on Anesthesia for Eye Surgery in what is considered the Reference textbook in Ophthalmology- Duane’s Clinical Ophthalmology -and has monitored all reports on the subject. The same cannot be said for needle or rigid long cannula delivered anesthesia. Dr. Greenbaum advises all to question their eye surgeons regarding the anesthesia planned prior to eye surgery.

Dr. Scott Greenbaum has served three times as President of the Ophthalmic Anesthesia Society, and has lectured across North America, Europe, and Asia at major meetings on the subject. He authored and edited Ocular Anesthesia, published by Harcourt, Brace, and holds a US Patent (pictured) for a novel instrument to be used safely to deliver complete anesthesia, eliminating needles from the procedure.