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Year : 2007  |  Volume : 55  |  Issue : 2  |  Page : 103-107

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

Gadkari Eye Centre, Pune, India

Correspondence Address:
Salil S Gadkari
Gadkari Eye Centre, Opposite Karve Road, Telephone Exchange, Pune - 411 004
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0301-4738.30702

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Background: Inadvertent globe perforation due to periocular injection is a serious iatrogenic complication. Aim: To study risk factors, management, and visual outcome of inadvertent globe perforation during periocular injection, in cases referred to a tertiary eye care center. Design and Setting: Retrospective study at a tertiary referral center with a single investigator. Materials and Methods: 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. Results: Retrobulbar injections 6 (32%), peribulbar injections 10 (53%), and subconjunctival injections 3 (16%) were responsible for inadvertent globe perforation. Anesthetists accounted for 6 (32%) injections and 13 (69%) were referred from high volume community settings. Anesthetists identified the mishap on the table in 17% (1 out of 6) of cases and the ophthalmologists in 69% (9 out of 13) myopia was present in 10 (53%). Breaks were located inferotemporally in nine eyes. Four underwent laser and cryopexy, 14 (74%) underwent vitreous surgery. Visual acuity greater than 20/200 was achieved in 12 patients. Conclusion: 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.

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