Primary use of silicone oil tamponade in the management of perforating globe injury secondary to inadvertent local anaesthesia injection for ophthalmic surgery

Perforating and penetrating globe injuries secondary to peribulbar and retr obulbar anaesthesia are often complicated by vitreous haemorrhage and retin al detachment. We describe the effectiveness of primary silicone oil tampon ade in the repair of three perforated globes secondary to local anaesthesia for ophthalmic surgery. Three patients with axial myopia had peribulbar and retrobulbar anaesthesia for extracapsular cataract extraction (two patients) and cryotherapy (one patient). All eyes sustained a vitreous haemorrhage obscuring the view to t he fundus. Retinal detachments were detected by B-scan ultrasound. In all e yes, scleral buckling, pars plana vitrectomy and silicone oil tamponade wer e performed as a primary surgical procedure. All the patients had complete anatomic reposition. In two patients, after two years follow-up, visual acu ity was between 6/12 to 6/36 with the retina attached and no proliferative vitreoretinopathy (PVR). The third patient had blind painful eye and enucle ation was performed. Primary use of silicone oil tamponade, in the manageme nt of perforated globe with retinal detachment due to local anaesthesia inj ection, is recommended.