in cataract surgery

Dear editor We read with interest the recently published article “Superior subconjunctival anes-thesia versus retrobulbar anesthesia for manual small-incision cataract surgery in a residency training program: a randomized controlled trial ” by Pipat Kongsap,1 where the author studied possible differences in the clinical outcomes of superior subconjunctival anesthesia and retrobulbar anesthesia, in a residency training program. Nowadays, two options are the most accepted in phacoemulsification anesthesia: topical anesthesia and regional anesthesia (retrobulbar and peribulbar).2 However, being strict with the concepts, if we talk about topical anesthesia, we should refer only to use of anesthetic eyedrops, whereas when we add intracameral lidocaine and/or sedation, we should be talking about a “combined form. ” When topical anesthesia alone is not possible, rather than perform a classical retrobulbar or peribulbar anes-thesia, we could choose an intermediate approach that would supplement the topical anesthesia with a “limited ” peribulbar anesthesia, to provide their benefits without the associated drawbacks