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Optic Neuropathy Secondary to Sub-Tenon Anesthetic Injection in Cataract Surgery
Arch Ophthalmol. 2003;121:907-909.
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Direct optic nerve injury secondary to retrobulbar injection is a relatively uncommon but significant cause of blindness following cataract surgery.1 Believed to be safer than retrobulbar or peribulbar anesthesia, sub-Tenon anesthesia nonetheless provides equally effective anesthesia and akinesia.2-4 Use of shorter, blunt-tipped needles with a more anterior site of injection are thought to reduce or eliminate the risk of optic nerve injury.2-4 To our knowledge, we report herein the first case of traumatic optic neuropathy secondary to sub-Tenon anesthesia and provide evidence of the mechanism of injury.
Report of a Case
A healthy 78-year-old man noted "total blindness" in his right eye just after an "uncomplicated" cataract extraction in that eye. Preoperatively, the patient had a Snellen visual acuity of 20/200 OD with macular fibrosis, and a 3+ nuclear sclerosis cataract on the right. Potential acuity meter readings showed a visual acuity of 20/60 OD and the axial length was 23.97 mm. Phacoemulsification had . . . [Full Text of this Article]
An Experiment With Sub-Tenon Cannulas
Comment
Corresponding author and reprints: Joseph F. Rizzo III, MD, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114 (e-mail: jrizzo@meei.harvard.edu).
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