Published online Mar 16, 2021. doi: 10.12998/wjcc.v9.i8.2001
Peer-review started: November 26, 2020
First decision: December 24, 2020
Revised: January 2, 2021
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: March 16, 2021
Processing time: 100 Days and 3.2 Hours
To report the possible reasons for needle perforation and complications related to perforation, as well as the clinical management of subretinal hemorrhage (SRH) during retrobulbar injection.
A 65-year-old female was scheduled to undergo pars plana vitrectomy (PPV) in her left eye for rhegmatogenous retinal detachment (RRD). During retrobulbar anesthesia, needle perforation of the globe occurred. Massive SRH in the inferotemporal quadrant together with vitreous hemorrhage were observed. The patient underwent PPV combined with retinotomy for removal of the massive SRH. After earlier surgical intervention, successful reattachment of the retina was achieved.
Inadvertent globe penetration during retrobulbar anesthesia is associated with a poor prognosis and may result in blindness. Timely detection and earlier intervention may be beneficial.
Core Tip: Inadvertent globe penetration during retrobulbar anesthesia is an uncommon and serious complication. We present a case of needle perforation of the globe during retrobulbar injection. We discuss the results of our literature search for evidence related to reasons for needle perforation and complications related to perforation, as well as the clinical management of subretinal hemorrhage, in an effort to encourage ophthalmologists to pay more attention to this sight-threatening complication. If iatrogenic perforations occur, timely detection and earlier intervention may be beneficial for prognosis.