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© 2002 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 21:1131-1135 • 0278-4297

Technical Advance

Guidance of Retrobulbar Injection With Real-time Tomographic Reflection

Wilson M. Chang, MS, George D. Stetten, MD, PhD, Louis A. Lobes, Jr, MD, Damion M. Shelton, BA, BS and Robert J. Tamburo, BS

Department of Bioengineering, University of Pittsburgh (W.M.C., G.D.S.), The Robotics Institute, Carnegie Mellon University (W.M.C., G.D.S., D.M.S.), and University of Pittsburgh Medical Center (W.M.C., L.A.L.), Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Wilson M. Chang, MS, Department of Bioengineering, University of Pittsburgh, 761 Benedum Hall, Pittsburgh, PA 15261.

Objective. Retrobulbar and peribulbar injections are common ophthalmologic procedures used to deliver anesthetics and other medications for ophthalmic therapy and surgery. These injections, typically performed without any type of guidance, can lead to complications that are rare but visually devastating. The needle may penetrate the optic nerve, perforate the globe, or disperse toxic quantities of drugs intraocularly, causing major visual loss. Sonographic guidance may increase the accuracy of the needle placement, thereby decreasing the incidence of complications. However, difficulties arise in coordinating the relative location of the image, the needle, and the patient. Real-time tomographic reflection is a new method for in situ visualization of sonographic images, permitting direct hand-eye coordination to guide invasive instruments beneath the surface of the skin. Methods. In this preliminary study, real-time tomographic reflection was used to visualize the eye and surrounding anatomic structures in a cadaver during a simulated retrobulbar injection. Results. The needle tip was easily followed as it was advanced into the retrobulbar space. Conclusions. The images presented in this preliminary study show the use of real-time tomographic reflection to visualize insertion of an invasive instrument into the human body.

Key Words: real-time tomographic reflection • retrobulbar injection • sonographic guidance • Sonic Flashlight • tomographic reflection

Abbreviations: HMD, head-mounted display • RTTR, real-time tomographic reflection




This article has been cited by other articles:


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W. M. Chang, N. B. Amesur, R. L. Klatzky, A. B. Zajko, and G. D. Stetten
Vascular Access: Comparison of US Guidance with the Sonic Flashlight and Conventional US in Phantoms
Radiology, December 1, 2006; 241(3): 771 - 779.
[Abstract] [Full Text] [PDF]


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Copyright © 2002 by the American Institute of Ultrasound in Medicine.