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Summary
Retrobulbar hemorrhage, a complication of anesthesia, does not always necessitate cataract surgery cancellation. Small-incision phacoemulsification can be safely performed if the globe is soft and eyelids are mobile after hemorrhage.
Area of Science:
- Ophthalmology
- Surgical Procedures
- Anesthesia Complications
Background:
- Retrobulbar hemorrhage is traditionally considered a contraindication for cataract surgery.
- Surgery cancellation due to retrobulbar hemorrhage causes patient and surgeon disappointment.
Purpose of the Study:
- To evaluate the safety of proceeding with small-incision phacoemulsification surgery following retrobulbar hemorrhage.
- To identify criteria for safely performing cataract surgery after a limited retrobulbar hemorrhage.
Main Methods:
- Retrospective study of 60 eyes.
- Assessed globe softness, retropulsion, eyelid mobility, and orbital tension.
- Surgery proceeded if digital massage achieved a soft globe and loose eyelids.
Main Results:
- Fifty-seven cases with retrobulbar hemorrhage met the criteria for proceeding.
- All 57 cases underwent successful small-incision phacoemulsification with intraocular lens implantation.
- No intraoperative or postoperative complications were observed in the cases performed.
Conclusions:
- Small-incision cataract surgery can be safely performed in the presence of limited retrobulbar hemorrhage.
- Specific criteria related to globe and eyelid status can guide the decision to proceed with surgery.
- This approach minimizes surgical cancellations and associated patient and surgeon dissatisfaction.