Repair of a ruptured globe using topical anesthesia.
We present a 76-year-old patient who had ocular trauma with dehiscence of the wound and scleral rupture with a prolapsed iris, ciliary body, intraocular lens, and vitreous after uneventful cataract surgery with a self-sealing sclerocorneal tunnel incision. General anesthesia was not possible because the patient had a history of lung cancer with extensive emphysema and unstable coronary disease. Local retrobulbar or peribulbar anesthesia was not considered because of the risk for further extrusion of intraocular contents. Topical anesthesia was applied with a 10.0 mm x 2.5 mm cellulose sponge soaked in oxybuprocaine 0.4% (Novesine) placed under the upper and lower lid for 20 minutes. Surgical repair of a 14.0 mm scleral wound was achieved without complication or pain during the procedure.
Auffarth
Gerd U
GU
Heidelberg IOL and Refractive Surgery Research Group, Department of Ophthalmology, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany.
Vargas
Luis G
LG
Klett
Jens
J
Völcker
Hans E
HE
D000058:Accidental Falls; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage; D015807:Eye Injuries, Penetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D005260:Female; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D007910:Lenses, Intraocular; D008175:Lung Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D011343:Procaine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D011391:Prolapse; D012421:Rupture; D012590:Sclera / Q000293:injuries*; D013529:Surgical Wound Dehiscence / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014603:Uveal Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*
D000779:Anesthetics, Local; D011343:Procaine; C005298:benoxinate