Evaluation of 19 cases of inadvertent globe perforation due to periocular injections

• Main Author: Gadkari Salil
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2007-01-01
• Series: Indian Journal of Ophthalmology
• Subjects: Globe perforation; inadvertent intraocular injection; periocular injection.
• Online Access: http://www.ijo.in/article.asp?issn=0301-4738;year=2007;volume=55;issue=2;spage=103;epage=107;aulast=Gadkari

<b>Background: </b> Inadvertent globe perforation due to periocular injection is a serious iatrogenic complication. <b> Aim:</b> To study risk factors, management, and visual outcome of inadvertent globe perforation during periocular injection, in cases referred to a tertiary eye care center. <b> Design and Setting:</b> Retrospective study at a tertiary referral center with a single investigator. <b> Materials and Methods:</b> Nineteen consecutive cases with a clinical diagnosis of globe perforation were studied (1998-2004). Clinical setting, risk factors, clinical presentation, management, and visual outcome were analyzed. <b> Results:</b> Retrobulbar injections 6 (32&#x0025;), peribulbar injections 10 (53&#x0025;), and subconjunctival injections 3 (16&#x0025;) were responsible for inadvertent globe perforation. Anesthetists accounted for 6 (32&#x0025;) injections and 13 (69&#x0025;) were referred from high volume community settings. Anesthetists identified the mishap on the table in 17&#x0025; (1 out of 6) of cases and the ophthalmologists in 69&#x0025; (9 out of 13) myopia was present in 10 (53&#x0025;). Breaks were located inferotemporally in nine eyes. Four underwent laser and cryopexy, 14 (74&#x0025;) underwent vitreous surgery. Visual acuity greater than 20/200 was achieved in 12 patients. <b> Conclusion: </b> Myopia was found to be a significant risk factor. Inferotemporal breaks were common. Anesthetists were more likely to miss this complication when it occurred. In this series, intervention salvaged vision in a significant number of eyes.