Inadvertent globe perforation during retrobulbar injection in high myopes

Abstract

Purpose: To report ocular perforation that occurred during retrobulbar injection in 7 highly myopic eyes.

Methods: Seven patients with a diagnosis of globe injury during retrobulbar injection for ocular anesthesia before cataract surgery were managed by vitreoretinal surgery. All injections were performed by ophthalmologists. The surgeon recognized the perforation in 4 cases at the time of injection. The preoperative vision was hand motion perception in 4 eyes and light perception in 3 eyes. All patients underwent vitreoretinal surgery because of the presence of vitreous hemorrhage and/or retinal detachment diagnosed by funduscopy or ultrasonography. At the time of surgery, all eyes had vitreous hemorrhage and 4 eyes had rhegmatogenous retinal detachment. The number of vitreoretinal procedures performed was: 1 procedure in 4 patients, 2 procedures in 2 patients, and 3 procedures in 1 patient. The period of follow-up ranged from 4 months to 4 years, averaging 20 months.

Results: At the end of the follow-up period, the retina was attached in 6 patients. The postoperative vision was 20/400 in 3 eyes, finger counting in 3 eyes, and light perception in 1 eye.

Conclusion: Special care should be taken in retrobulbar injection of highly myopic globes, which have an increased risk of perforation. The functional outcome of surgical repair of these eyes was poor.