The Sprotte Needle
Approximately 5,000 eye surgeries are performed annually at the Spokane Eye Center in Spokane, Washington. Of those surgeries, 3,000 to 4,000 require retrobulbar blocks for anesthesia. Dan Simonson, CRNA, performs a high volume of retrobulbar blocks, which he prefers to the use of topical anesthesia.
The risk of puncture is eliminated with topical eye anesthesia, but other risks arise. “Centers that do a high volume of cataract surgical procedures get good at topical anesthesia,” Simonson says. “But the additional risks of topical anesthesia are that the patient will not be able to tolerate the procedure and the procedure will have to be aborted. Additionally, there may be an unforeseen complication during the procedure, such as a dropped lens nucleus or choroidal hemorrhage. Complications like this would become more difficult to control with an unanesthetized eye.”
The standard needle used in retrobulbar procedures is a disposable 25 to 27 gauge, 1 to 11/2” needle. The risks of using such a needle in retrobulbar blocks include tearing tissue of the eye and perforating the globe. The Sprotte needle, which Simonson uses in every retrobulbar block he performs, greatly reduces that risk. “The Sprotte needle, because of its design, travels through the tissues of the orbit without cutting them. Additionally, it is very difficult to penetrate the sclera with the needle, even at the 25 gauge size,” Simonson says.
