Dai Ying, Sun Tao, Gong Jun-Fang
Department of Ophthalmology, The Fourth Affiliated Hospital of Nantong University/The First People's Hospital of Yancheng, Yancheng 224000, Jiangsu Province, China.
World J Clin Cases. 2021 Mar 16;9(8):2001-2007. doi: 10.12998/wjcc.v9.i8.2001.
To report the possible reasons for needle perforation and complications related to perforation, as well as the clinical management of subretinal hemorrhage (SRH) during retrobulbar injection.
A 65-year-old female was scheduled to undergo pars plana vitrectomy (PPV) in her left eye for rhegmatogenous retinal detachment (RRD). During retrobulbar anesthesia, needle perforation of the globe occurred. Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed. The patient underwent PPV combined with retinotomy for removal of the massive SRH. After earlier surgical intervention, successful reattachment of the retina was achieved.
Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness. Timely detection and earlier intervention may be beneficial.
报告球后注射时针头穿孔的可能原因及与穿孔相关的并发症,以及视网膜下出血(SRH)的临床处理。
一名65岁女性计划在左眼行玻璃体切割术(PPV)治疗孔源性视网膜脱离(RRD)。在球后麻醉期间,发生了眼球的针头穿孔。观察到颞下象限出现大量SRH并伴有玻璃体积血。患者接受了PPV联合视网膜切开术以清除大量SRH。经过早期手术干预,视网膜成功复位。
球后麻醉期间意外的眼球穿透与预后不良相关,可能导致失明。及时发现和早期干预可能有益。