Background: 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.
Case summary: 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.
Conclusion: 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.
Keywords: Case report; Globe penetration; Needle perforation; Pars plana vitrectomy; Retinotomy; Retrobulbar anesthesia; Subretinal hemorrhage.
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