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Volume 13
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10.3390/life13061390
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Case Report

Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review

by
Alessandra Scampoli
1,*,
Lorenzo Governatori
1,
Patrizio Bernardinelli
2,3,
Stefano Maria Picardi
4,
Carola Culiersi
2,3 and
Tomaso Caporossi
1,2
1
Vitreoretinal Surgery Unit, Fatebenefratelli Isola Tiberina-Gemelli Isola Hospital, 00186 Rome, Italy
2
Catholic University of the Sacred Heart, 00168 Rome, Italy
3
Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy
4
Ophthalmology Unit, ASST Melegnano e Della Martesana, 20070 Vizzolo Predabissi, Italy
*
Author to whom correspondence should be addressed.
Life 2023, 13(6), 1390; https://doi.org/10.3390/life13061390
Submission received: 20 April 2023 / Revised: 7 June 2023 / Accepted: 12 June 2023 / Published: 14 June 2023
(This article belongs to the Special Issue Novel Diagnosis and Therapeutics Approaches in Retina Diseases)
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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.
Keywords: rhegmatogenous retinal detachment; vitrectomy; vitreoretinal surgery; peribulbar anesthesia; needle injury; macular break; inverted flap; ocular perforation; vitreous hemorrhage rhegmatogenous retinal detachment; vitrectomy; vitreoretinal surgery; peribulbar anesthesia; needle injury; macular break; inverted flap; ocular perforation; vitreous hemorrhage

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MDPI and ACS Style

Scampoli, A.; Governatori, L.; Bernardinelli, P.; Picardi, S.M.; Culiersi, C.; Caporossi, T. Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review. Life 2023, 13, 1390. https://doi.org/10.3390/life13061390

AMA Style

Scampoli A, Governatori L, Bernardinelli P, Picardi SM, Culiersi C, Caporossi T. Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review. Life. 2023; 13(6):1390. https://doi.org/10.3390/life13061390

Chicago/Turabian Style

Scampoli, Alessandra, Lorenzo Governatori, Patrizio Bernardinelli, Stefano Maria Picardi, Carola Culiersi, and Tomaso Caporossi. 2023. "Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review" Life 13, no. 6: 1390. https://doi.org/10.3390/life13061390

APA Style

Scampoli, A., Governatori, L., Bernardinelli, P., Picardi, S. M., Culiersi, C., & Caporossi, T. (2023). Inverted ILM Flap for a Needle Injury to the Macula after Peribulbar Anaesthesia: A Case Report and Literature Review. Life, 13(6), 1390. https://doi.org/10.3390/life13061390

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