Risks and sequelae of scleral perforation during peribulbar or retrobulbar anesthesia.
نویسندگان
چکیده
PURPOSE To assess the risk for and circumstances of serious complications during peribulbar and retrobulbar anesthesia. SETTING University eye departments, Freiburg and Würzburg, Germany, and Skopje, Macedonia. METHODS This retrospective analysis comprised patients who received secondary care for complications of inadvertent globe perforation during peribulbar or retrobulbar injections over a 17-year period. RESULTS The review identified 9 inadvertent globe perforations that led to a variety of complications, ranging from subretinal hemorrhage to a globe rupture. Two cases were minor (subretinal hemorrhage with spontaneous resorption and retinal break requiring photocoagulation). All other cases required 1 or more vitrectomies to resolve intraocular hemorrhage and retinal detachment. Most cases still had significant functional impairment after treatment. Two of the 9 eyes regained reading ability, 1 eye maintained no light perception acuity, and 6 eyes had ambulatory vision only. CONCLUSIONS Although perforation is a rare complication of peribulbar anesthesia in normal eyes, the severity of complications in this study point to the importance of giving all patients, not only those with risk factors (eg, myopia, scar formation), detailed information about the possible risks and complications of peribulbar injections compared with those of other methods such as topical anesthesia and general anesthesia.
منابع مشابه
Perforation of the globe--a complication of peribulbar anaesthesia.
Peribulbar anaesthesia has been recommended as a safer alternative to retrobulbar anaesthesia. We report a case of perforation of the globe sustained during peribulbar anaesthesia which resulted in blindness. Orbital injections are potentially dangerous, be they peribulbar or retrobulbar. To minimise the risk, short, blunt needles are advocated for the peribulbar route.
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BACKGROUND Peribulbar and retrobulbar anesthesia have long been opposed on the basis of the existence of an intermuscular membrane, which is supposed to separate the intraconal from the extraconal spaces in a water-tight fashion. A local anesthetic injected outside the cone should spread through this septum to reach the nerves to be blocked. The existence of this septum is questioned. The aim o...
متن کاملIntraocular anesthetic following peribulbar anesthesia.
The incidence of globe perforation following peribulbar anesthesia is rare, occurring in 0.006% of the cases in a recent series. The incidence of intraocular anesthetic injection is also rare; only 4 cases have been reported in the Englishlanguage literature. We report a case of an intraocular injection of a combination of bupivacaine hydrochloride and mepivacaine hydrochloride following globe ...
متن کامل361-367 Erdurmus:Shoja
For many years, retrobulbar and peribulbar anesthesia were the standard for cataract surgery; however, many serious adverse effects have been reported (1, 2). With the introduction of modern phacoemulsification cataract surgery, topical anesthesia without retrobulbar or periocular injections has become a well-established, minimally invasive technique (3). The addition of intracameral lidocaine ...
متن کاملExtracapsular cataract extraction under local anaesthesia without retrobulbar injection.
Day-case cataract surgery and the need for local anaesthesia are likely to increase. Retrobulbar (and peribulbar) anaesthetic injection is a common technique in cataract surgery, but serious complications are persistently reported. Subconjunctival injection is an alternative that avoids these risks. This retrospective study compares two groups of patients that underwent extracapsular cataract s...
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ورودعنوان ژورنال:
- Journal of cataract and refractive surgery
دوره 36 6 شماره
صفحات -
تاریخ انتشار 2010