title: Endophthalmitis due to inadvertent globe penetration during retrobulbar injection of saline solution for laser in situ keratomileusis.
abstract: A 31-year-old woman presented with visual acuity of counting fingers and presumed bacterial endophthalmitis in the left eye 10 days after refractive surgery. During the procedure, a retrobulbar injection of balanced salt solution had been performed to assist with globe suction by the microkeratome. A perforation site was identified in the inferonasal retina. Following intravitreal antibiotic injection and surgical intervention, the visual acuity returned to 20/20. Retrobulbar injection to facilitate laser in situ keratomileusis carries risks. Careful monitoring for signs of infection is recommended if globe perforation is recognized.
authors.affiliation: Department of Ophthalmology, University of California, San Francisco, California 94143-0730, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Han
authors.forename: Har Hiu
authors.initials: HH
authors.lastname: Lam
authors.forename: Jay M
authors.initials: JM
authors.lastname: Stewart
mesh_terms: D000085:Acetates / Q000008:administration & dosage*; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004338:Drug Combinations; D009877:Endophthalmitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D015807:Eye Injuries, Penetrating / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006801:Humans; D007267:Injections; D020731:Keratomileusis, Laser In Situ; D008903:Minerals / Q000008:administration & dosage*; D016602:Needlestick Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D009915:Orbit / Q000293:injuries*; D012160:Retina / Q000293:injuries*; D012965:Sodium Chloride / Q000008:administration & dosage*; D014463:Ultrasonography; D014792:Visual Acuity; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D014823:Vitreous Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery
chemical_list: D000085:Acetates; D000900:Anti-Bacterial Agents; C030660:BSS solution; D004338:Drug Combinations; D008903:Minerals; D012965:Sodium Chloride