Swept source optical coherence tomography in globe perforation

Dubey, Devashish; Shanmugam, Mahesh P; Ramanjulu, Rajesh; Mishra, Kapil; Doshi, Bindiya

doi:10.4103/ijo.ijo_738_19

Cited by 3 publications

(3 citation statements)

References 4 publications

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“…have also reported a similar case where in good anatomical and visual outcome was achieved despite a double penetration during peribulbar anesthesia. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Inadvertent triple globe penetration during peribulbar anesthesia

Poornachandra,

Hande,

Thomas

et al. 2024

Oman Journal of Ophthalmology

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Inadvertent globe perforation following peribulbar anesthesia can lead to unpleasant experiences if not identified early and managed appropriately. We present the case of a 75-year-old female who came with decreased vision in the left eye (LE) following cataract surgery under peribulbar block. Her visual acuity in the right eye (RE) was 6/24 and LE was 6/75. Fundus examination of LE showed vitreous hemorrhage with localized subretinal hemorrhage along the inferotemporal arcade suggestive of globe perforation. Optical coherence tomography (OCT, Spectralis. Heidelberg imaging, Germany) scan across the perforation site showed subretinal hemorrhage and full-thickness retinal tear. On follow-up, two more focal points of retinal whitening were noted in the inferotemporal equatorial region. The patient was kept under close monitoring, and 4 weeks later, vision improved to 6/9 and barrage laser was done around the perforation sites. Serial OCT scans and close follow-up in iatrogenic globe perforation can result in good visual outcomes.

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“…have also reported a similar case where in good anatomical and visual outcome was achieved despite a double penetration during peribulbar anesthesia. [ 7 ]…”

Section: Discussionmentioning

confidence: 99%

Inadvertent triple globe penetration during peribulbar anesthesia

Poornachandra,

Hande,

Thomas

et al. 2024

Oman Journal of Ophthalmology

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show abstract

“…Regarding the inverted flap technique, the introduction of the use of layered tissue for retinal wound closure dates to 2010, when Michalewska published the idea of using an inverted ILM flap over idiopathic MHs [ 25 ]. The technique has been adopted all over the world and adapted for the treatment of larger and chronic idiopathic MH, myopic MH, and, lastly, posterior retinal tears as we described in this case report [ 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

“…The reported cause of poor final BCVA in eyes complicated with RD include epiretinal membrane formation, macular injury due to a needle, optic atrophy, SRH, CD, and vascular occlusion [ 26 , 27 , 28 , 29 , 30 , 31 ]. In our case, perforation signs such as VH, SRH, and RD were noted, leading to a high risk for PVR-complicated RD development.…”

Section: Discussionmentioning

confidence: 99%

Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review

Scampoli

Governatori

Bernardinelli

et al. 2023

Life

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Globe perforation following peribulbar anesthetic injection is a rare but dreaded complication that often results in poor visual outcomes. This case report is on a female patient who sustained vitreous hemorrhage, retinal detachment, and macular breaks due to a peribulbar block administered in the setting of cataract extraction. The retina was repaired with pars plana vitrectomy, endolaser of the peripheral retinal break only, and an internal limiting membrane inverted flap for the macular breaks to avoid the endolaser on the macular area, achieving stable visual outcomes. The authors discussed various modes of local anesthesia for vitreoretinal surgery, risks for globe perforations, and how to approach retinal detachment secondary to needle perforations, which are complex cases at high risk for proliferative vitreoretinopathy. Early recognition and intervention in eyes with an inadvertent perforation can lead to a good outcome. Eyes with a longer axial length, superior, and multiple perforations are at higher risk of developing complications such as retinal detachment and vitreous hemorrhage. Complications such as retinal detachment, macular injury, and vascular occlusion are risk factors for poor prognosis.

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Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

Babu

Kumar

Kohli

et al. 2022

Korean J Ophthalmol

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Purpose: To evaluate the clinical presentation, management, and outcome of eyes with an inadvertent globe perforation during peribulbar or retrobulbar block.Methods: This retrospective study evaluated the eyes which had an accidental globe perforation during local ocular anesthesia from 2012 to 2020. The patients were divided into three groups: group 1, Clear media with no rhegmatogenous retinal detachment (RRD); group 2, significant vitreous hemorrhage (VH) precluding the retinal view without RRD; and group 3, RRD with/without VH.Results: Twenty-five patients were included in the study. The mean axial length (AL) was 24.7 ± 2.7 mm (range, 20.9–31.2 mm). The most common presenting feature was VH (n = 14). The treatment included retinal laser barrage (n = 7) and vitrectomy (n = 17). Retinal breaks were identified in all the eyes (total breaks = 37). The mean presenting best-corrected visual acuity in groups 1, 2, and 3 were logarithm of the minimum angle of resolution 0.79 ± 0.73, 1.82 ± 0.78, and 2.13 ± 0.59 respectively. All the treated patients had an attached retina at the last follow-up. The mean final best-corrected visual acuity for each group was logarithm of the minimum angle of resolution 0.59 ± 0.79, 0.48 ± 0.26, and 1.25 ± 0.64, respectively (p = 0.006). The development of RRD was associated with a larger AL (p = 0.015); while the development of significant VH associated with the superior location of the perforation (p = 0.015), late recognition of the perforation (p = 0.004), and multiple perforations (p = 0.015).Conclusions: Early recognition and intervention in eyes with an inadvertent perforation can lead to a good outcome. Eyes with a longer AL, superior, and multiple perforations are at higher risk of developing complications like RRD and VH. Complications like RRD, macular injury, and vascular occlusion are risk factors for poor prognosis.

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Swept source optical coherence tomography in globe perforation

Cited by 3 publications

References 4 publications

Inadvertent triple globe penetration during peribulbar anesthesia

Inadvertent triple globe penetration during peribulbar anesthesia

Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review

Clinical Presentation and Management of Eyes with Globe Perforation during Peribulbar and Retrobulbar Anesthesia: A Retrospective Case Series

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