Abstract | PURPOSE: SETTING: Department of Ophthalmology, Ludwig-Maximilans Universität, München, Germany. DESIGN: Retrospective study. METHODS: Two groups of patients were screened retrospectively over a 5-year period for the inclusion criterion of severe retrobulbar hematoma after retrobulbar or parabulbar injection. The first group consisted of emergency cases referred to the clinic. A second group of patients had received retrobulbar block at the hospital. All cases were collected and screened for the presence of antiplatelet therapy. RESULTS: Among roughly 160 000 patient records screened, 3 patients with grade IV retrobulbar hematoma were identified. Two of these patients were taking dual antiplatelet medications and 2 were on anticoagulation therapy during the time of retrobulbar or peribulbar anesthesia. None of the cases showed single medication platelet inhibition. The visual acuity of all patients stayed low at the 6-month follow-up (1.2 logMAR in 1 patient and no light perception in 2 patients). CONCLUSIONS: Retrobulbar hematoma is a rare but severe complication of retrobulbar anesthesia. With the high prevalence of dual platelet inhibition found in these cases, a prospective controlled trial seems unethical. In these high-risk patients, surgery should be performed under topical anesthesia if possible or general anesthesia if necessary. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.
|
Authors | Irene Huebert, Norbert Heinicke, Daniel Kook, Kim A Boost, Christina V Miller, Wolfgang J Mayer, Christos Haritoglou, Anselm Kampik, Arnd Gandorfer, Christoph Hintschich, Armin Wolf |
Journal | Journal of cataract and refractive surgery
(J Cataract Refract Surg)
Vol. 41
Issue 10
Pg. 2092-101
(Oct 2015)
ISSN: 1873-4502 [Electronic] United States |
PMID | 26703284
(Publication Type: Case Reports, Comparative Study, Journal Article)
|
Copyright | Copyright © 2015. Published by Elsevier Inc. |
Chemical References |
- Anticoagulants
- Drug Combinations
- Platelet Aggregation Inhibitors
- Warfarin
- Clopidogrel
- Ticlopidine
- Aspirin
|
Topics |
- Aged
- Anesthesia, Local
(methods)
- Anticoagulants
(adverse effects, therapeutic use)
- Arterial Occlusive Diseases
(drug therapy)
- Aspirin
(adverse effects, therapeutic use)
- Cardiac Surgical Procedures
- Cardiovascular Diseases
(drug therapy)
- Clopidogrel
- Drug Combinations
- Female
- Humans
- Lens Implantation, Intraocular
- Male
- Phacoemulsification
- Platelet Aggregation Inhibitors
(adverse effects, therapeutic use)
- Retrobulbar Hemorrhage
(chemically induced, diagnosis, surgery)
- Retrospective Studies
- Risk Factors
- Ticlopidine
(adverse effects, analogs & derivatives, therapeutic use)
- Warfarin
(adverse effects, therapeutic use)
|