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Technique of scleral buckling for retinal detachment repair
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Scleral buckling can be performed under either local or general anesthesia, and the choice is often a function of surgeon preference and community standard of care. The advantages of local anesthesia include shorter operating time, quicker postoperative recovery, and decreased systemic morbidity. Potential risks include perforation of the globe (especially in myopic eyes), retrobulbar hemorrhage, retinal vascular occlusion, optic nerve injury, and brainstem anesthesia leading to respiratory arrest and grand-mal seizures.4 Peribulbar anesthesia may reduce these complications. The major disadvantage of local anesthesia is inadequate analgesia, which may occur in up to 10% of cases. If a two-injection technique is used for peribulbar anesthesia, the injection in the superior orbit should be given first to reduce the risk of globe perforation.5
Demographics of Facial Injuries
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Keith E. Follmar, Eduardo D. Rodriguez
Immediate posttraumatic blindness occurs in 1.6% to 5% of patients with midface fractures. It is more commonly seen with higher-energy mechanisms, such as MVCs, compared with lower-energy mechanisms, such as assault. Posttraumatic blindness can be caused by direct injury to the globe, retinal vascular occlusion, orbital compartment syndrome (retrobulbar hemorrhage), retinal detachment, or injury to proximal structures (the optic nerve, optic tract, or central vision centers).
Applications of bupivacaine in the non-surgical treatments of strabismus: a review
Published in Strabismus, 2022
Mohammad Yaser Kiarudi, Seyed Hossein Ghavami Shahri, Acieh Es’haghi, Bahare Gharib, Mohammad-Reza Ansari-Astaneh
The main injection should be performed in 1/3 of the muscle to posterior third of the muscle. The BUP can be used in conjunction with epinephrine 1/100000, assuming that vasoconstriction increases tissue contact and performance. In a recent study by Sadeghi et al., BUP injection was performed without the use of electromyographic guidance.25 The BUP is cardiotoxic in intravenous doses above 1.5 mg/kg. In intravitreal injections, this risk is low, and it is necessary to ensure the absence of intravenous injection. The BUP myotoxicity can cause slight swelling due to muscle necrosis. Consequently, in some studies, oral prednisolone has been used for up to 2 weeks after injection. In most studies, no side effects have been reported except pain and chemosis. Only in a study by Hopker et al., one case of retrobulbar hemorrhage was reported, which was treated with ocular pressure and intraocular pressure control; moreover, after 2 weeks, there was no change in visual acuity.9
Spontaneous retrobulbar hemorrhage in the setting of warfarin therapy and latent scurvy diagnosis
Published in Orbit, 2022
Brian W. Chou, Quinn N. Rivera, Courtney E. Francis
Retrobulbar hemorrhage is a vision-threatening emergency that most commonly occurs in the setting of facial trauma or surgical manipulation, presenting with sudden onset of pain, pressure, proptosis, and ophthalmoplegia. Rapid canthotomy and cantholysis to release the orbital compartment must be undertaken to prevent vision loss.1 Spontaneous nontraumatic hemorrhages are much rarer, and a thorough evaluation must be considered in patients. anti-coagulation alone, in the absence of supratherapeutic levels, is unlikely to cause a nontraumatic retrobulbar hemorrhage, and other contributing factors should be considered, including orbital vascular anomalies. Larger malformations may be easily identifiable on imaging, but smaller vessel weaknesses may be more difficult to identify.
Outcomes of pediatric accommodative esotropia with botulinum toxin A treatment in Thailand
Published in Strabismus, 2021
Nutsuchar Wangtiraumnuay, Supawan Surukrattanaskul, Thamolwan Surakiatchanukul, Patcharapim Masaya-Anon, Juthathip Hiriotappa
Botulinum toxin injection was used as strabismus treatment for the first time by Dr. Alan Scott in the United States in 1981. It was then used in many types of strabismus such as esotropia, exotropia, residual strabismus and neurological strabismus. Previous reports showed that the result of its use was more effective for esotropia than for exotropia.3–8 Common complications after botulinum toxin injection were ptosis, consecutive strabismus, hypertropia, and subconjunctival hemorrhage. Loss of vision was found in 0%, while vision-threatening complications such as scleral perforation and retrobulbar hemorrhage were found in less than 0.005%.,4,9–11 Botulinum toxin injection was reported to be effective for some types of esotropia such as cranial nerve VI palsy, residual esotropia, consecutive esotropia and also used adjunct to conventional surgery.,12,13 In childhood acute onset esotropia, the use of botulinum toxin showed better outcomes than traditional surgery.13,14 The success rate of botulinum toxin injection in esotropia treatment varies from 37% to 70% with a 70% success rate in partial accommodative esotropia after follow-up at 18 months12, 50% success rate in infantile esotropia,13 and 37% success rate in esotropia.3