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Myopia a risk factor for globe perforation from periocular injection
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Myopia may be a significant risk factor for accidental globe perforation during periocular injections, according to a retrospective study by a surgeon in India.
Salil S. Gadkari, MD, reviewed records for 19 patients diagnosed with globe perforation referred to his center. The perforations were caused by retrobulbar injections in six cases (32%), by peribulbar injections in 10 cases (53%) and by subconjunctival injections in three cases (16%), according to the study.
Dr. Gadkari found that the injections had been performed by anesthetists in six cases (32%) and by ophthalmologists in 13 (69%) cases. However, anesthetists identified the perforation in only one of the six cases (17%), while ophthalmologists identified the problem before surgery in nine of the 13 cases (69%).
Myopia represented the most common risk factor for globe perforation and was present in 10 of the 19 patients (53%). Surgery was performed in 18 eyes; four patients were treated with laser and cryopexy and 14 patients were treated with pars plana vitrectomy. At 6 weeks follow-up, 12 patients achieved a visual acuity greater than 20/200, Dr. Gadkari reported.
The study is published in the March/April issue of Indian Journal of Ophthalmology.