Evaluation of 19 cases of inadvertent globe perforation due to periocular injections.
BACKGROUND
Inadvertent globe perforation due to periocular injection is a serious iatrogenic complication.


OBJECTIVE
To study risk factors, management and visual outcome of inadvertent globe perforation during periocular injection, in cases referred to a tertiary eye care center.


METHODS
Retrospective study at a tertiary referral center with a single investigator.


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.


CONCLUSIONS
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.
Gadkari
Salil S
SS
Gadkari Eye Centre, Pune, India. doc2gadkari@vsnl.com
D003228:Conjunctiva; D003452:Cryosurgery / Q000379:methods; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007267:Injections / Q000009:adverse effects; D053685:Laser Therapy / Q000379:methods; D016602:Needlestick Injuries / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D009915:Orbit; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015599:Trauma Severity Indices; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods