INTRODUCTION: An increasing number of cases are being recognized in which a peribulbar anesthetic for @entity231 surgery has been inadvertently injected directly into the globe under high pressure until the globe @entity397 or explodes. We reviewed the records of 6 such cases (one of which was reported previously by us), and one additional case has been reported in the literature. Surprisingly, 2 of these 7 cases went unrecognized at the time, and the surgeons proceeded with the @entity231 operation; all of the @entity1 ultimately developed severe @entity227 . OBJECTIVES: To reproduce this eye explosion in a live anesthetized @entity95 model and to perform a clinical, histopathological, experimental, biophysical, and mathematical analysis of this injury. METHODS: Eyes of live anesthetized @entity95 were @entity397 by means of the injection of saline directly into the globe under high pressure. The clinical and pathological findings of the @entity397 @entity1 and animal eyes were documented photographically and/or histopathologically. An experimental, biophysical, and mathematical analysis of the pressures and forces required to @entity397 the globe via direct injection using @entity1 cadavers, @entity1 @entity735 , and classic physics and ophthalmic formulas was performed. The laws of Bernoulli, LaPlace, Friedenwald, and Pascal were applied to the theoretical and experimental models of this phenomenon. RESULTS: The clinical and pathological findings of @entity397 , @entity1713 , @entity548 , and lens extrusion were observed. In the exploded @entity1 and @entity95 eyes, the @entity397 appeared at the equator, the limbal area, or the posterior pole. In 2 of the 7 @entity1 eyes, the anterior segments appeared entirely normal despite the @entity397 , and @entity231 surgery was completed; surgery was canceled in the other 4 cases. In 4 of the 5 injected and @entity397 @entity95 eyes, the anterior segments appeared essentially normal. The experiments with @entity1 @entity735 and the theoretical analyses of this entity show that the pressure required to produce such an injury is much more easily obtained with a 3- or 5-mL syringe than with a syringe 10 mL or larger. CONCLUSIONS: Explosion of an eyeball during the injection of anesthesia for ocular surgery is a devastating injury that may go unrecognized. The probability of an ocular explosion can be minimized by careful use of a syringe 10 mL or larger with a blunt needle, by discontinuing the injection if resistance is met, and by inspecting the globe prior to ocular massage or placement of a Honan balloon. When ocular explosion occurs, immediate referral to and intervention by a vitreoretinal surgeon is optimal. Practicing ophthalmologists should be aware of this blinding but preventable complication of ocular surgery.

Ocular explosion during XXXX surgery: a clinical, histopathological, experimental, and biophysical study.

@entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity227 :: ('MESH:D014786', 'Disease') :: ['visual loss and/or loss of the eye'] @entity231 :: ('MESH:D002386', 'Disease') :: ['cataract'] @entity548 :: ('MESH:D006470', 'Disease') :: ['vitreous hemorrhage'] @entity1713 :: ('MESH:D012163', 'Disease') :: ['retinal detachment'] @entity95 :: ('9986', 'Species') :: ['rabbits', 'rabbit'] @entity735 :: ('MESH:D005124', 'Disease') :: ['eye-bank eyes'] @entity397 :: ('MESH:D012421', 'Disease') :: ['ruptures', 'scleral rupture', 'scleral ruptures', 'ruptured', 'rupture']
@entity231 :: (MESH:D002386,Disease) :: ['cataract']
