Outcomes of ocular perforation following local anaesthesia

Session Details

Session Title: Presented Poster Session: Infection & Imaging

Venue: Poster Village: Pod 2

First Author: : R.Elsheikh EGYPT

Co Author(s): :    A. Elhusseiny   Y. Ismail   H. Elsheikh   A. Awadein              

Abstract Details

Purpose:

To identify the risk factors for scleral perforation following local anesthesia, time of identification, common sites for perforation, lines of management, and the final visual outcome.

Setting:

Kasr Al-Ainy Hospitals, Cairo University, Egypt.

Methods:

A retrospective chart review was done on patients diagnosed with scleral perforation during local anesthesia for cataract surgery in Cairo University Hospitals during the period from January 2013 through December 2017. Charts were reviewed for risk factors, site of perforation, management and the final post intervention visual acuity.

Results:

A total of 20 patients had scleral perforation out of 17512 patients who had cataract surgery under local anesthesia (0.36%). Perforation was discovered intraoperatively in 16 cases (80%).Main risk factors were posterior staphyloma (45%) and long axial length (40%). Conservative treatment was adopted in 2 patients, laser photocoagulation in 3 patients, and vitrectomy in 12 patients. The median final visual acuity was 0.2. Final visual outcome was significantly worse in those with central breaks , suprachoroidal hemorrhage , and in the vitrectomy group. There was no relation between the time of intervention and the final visual outcome

Conclusions:

While perforation might occur more commonly in those with posterior staphyloma, even eyes with normal axial length might be affected. Visual outcome might be permanently affected even after surgical management of its complications. Early and proper management of such cases can help reduce its grave effects on vision.

Financial Disclosure:

None