PDF(Pubmed)
Abstract：
Globe perforation following peribulbar anesthetic injection is a rare but dreaded complication that often results in poor visual outcomes. This case report is on a female patient who sustained vitreous hemorrhage, retinal detachment, and macular breaks due to a peribulbar block administered in the setting of cataract extraction. The retina was repaired with pars plana vitrectomy, endolaser of the peripheral retinal break only, and an internal limiting membrane inverted flap for the macular breaks to avoid the endolaser on the macular area, achieving stable visual outcomes. The authors discussed various modes of local anesthesia for vitreoretinal surgery, risks for globe perforations, and how to approach retinal detachment secondary to needle perforations, which are complex cases at high risk for proliferative vitreoretinopathy. Early recognition and intervention in eyes with an inadvertent perforation can lead to a good outcome. Eyes with a longer axial length, superior, and multiple perforations are at higher risk of developing complications such as retinal detachment and vitreous hemorrhage. Complications such as retinal detachment, macular injury, and vascular occlusion are risk factors for poor prognosis.
摘要：
球周注射麻醉药后的球形穿孔是一种罕见但可怕的并发症，通常会导致视力不良。本病例报告是关于一名持续玻璃体出血的女性患者，视网膜脱离,和黄斑破裂，由于在白内障摘除的背景下进行的球周阻滞。用平坦部玻璃体切除术修复了视网膜，仅周边视网膜破裂的内激光，和一个用于黄斑破裂的内界膜倒置瓣，以避免黄斑区域的眼内压，实现稳定的视觉效果。作者讨论了玻璃体视网膜手术的各种局部麻醉方式，地球穿孔的风险，以及如何接近针眼穿孔继发的视网膜脱离，这是增生性玻璃体视网膜病变高风险的复杂病例。对无意穿孔的眼睛进行早期识别和干预可以导致良好的结果。眼睛轴向长度较长，上级,多个穿孔发生并发症的风险较高，如视网膜脱离和玻璃体出血。并发症如视网膜脱离,黄斑损伤,血管闭塞是预后不良的危险因素。
