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A rare case of retained intraorbital needle fragment complicating retrobulbar anesthesia is reported. Prompt combined open exploration, removal of the needle fragment, and subsequent phacoemulsification and intraocular lens implantation resulted in unveventful recovery with a best-corrected visual acuity of 20/30 OD. Although serious needle-related complications are not common, they could be sight- or even life-threatening. The "needle-free" techniques of administering local anesthesia by topical drops or by sub-Tenon infusion with a plastic cannula may eliminate such complications and are therefore worth considering.
A 71-year-old Chinese woman originally scheduled for cataract surgery on the right eye was referred to us for further management of a retained intraorbital fragment from a broken retrobulbar needle following the retrobulbar injection of the anesthetic solution. The needle was a metallic reusable 25-gauge retrobulbar needle that was 3.8 cm long. The needle had broken at the hub-needle junction with its shaft left intraorbitally. The patient experienced nausea and diminished movements of the right eye, but no impairment of vision.
Lam DSC, Law RWK, Leung ATS, Chan W, Cheng ACK, Shum W. Intraorbital Needle Fragment: A Rare Complication of Retrobulbar Injection. Arch Ophthalmol. 1999;117(8):1089–1090. doi:
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