2020–2021 BCSC Basic and Clinical Science Course™
12 Retina and Vitreous
Part III: Selected Therapeutic Topics
Chapter 20: Vitreoretinal Surgery and Intravitreal Injections
Vitrectomy for Posterior Segment Complications of Anterior Segment Surgery
Needle Penetration of the Globe
Factors predisposing patients to needle penetration of the globe include
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axial high myopia
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inexperience of the practitioner
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poor patient cooperation at the time of the injection
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posterior staphyloma
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previous scleral buckling surgery
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scleromalacia
Management options vary with the severity of the intraocular damage. Often, blood obscures and surrounds the retinal penetration site, making laser treatment difficult. Observation or transscleral cryotherapy may be considered in such cases. When retinal detachment is present, early vitrectomy with or without scleral buckling is often recommended. Posterior pole damage from needle extension into the macula or optic nerve is associated with a very poor visual prognosis (Fig 20-12).
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.