Inadvertent globe perforation during retrobulbar injection in high myopes.

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.