Retrobulbar hemorrhage.

Retrobulbar hemorrhage associated with retrobulbar anesthesia has been construed as a contraindication to cataract surgery. Cancellation of the surgery results in disappointment for both the patient and surgeon. A retrospective study of 60 eyes was undertaken to evaluate the safety of proceeding with small-incision phacoemulsification surgery after retrobulbar hemorrhage when specific criteria are met. If digital massage achieved a soft globe that was easily retropulsed and the eyelids were loose and easily mobilized, the surgery was performed as scheduled. If the globe remained firm within a tense orbit and proptosis with tight lids was present, surgery was cancelled. Fifty-seven cases with retrobulbar hemorrhage met these criteria and underwent phacoemulsification with implantation of a posterior chamber intraocular lens. The lack of intraoperative and postoperative complications suggests that small-incision cataract surgery can be safely performed when preceded by a limited retrobulbar hemorrhage.