Orbital inflammation after sub-Tenon's anesthesia.
Two cases of orbital swelling after sub-Tenon's anesthesia are reported. The first patient presented 3 days postoperatively with proptosis and conjunctival chemosis. Computed tomography showed nonspecific inflammation of the orbital soft tissue. Signs and symptoms resolved after systemic steroids. The second patient presented with similar signs and mild pain on the fourth postoperative day. Computed tomography showed a similar diffuse orbital inflammation. The patient was treated with oral steroids and antibiotics, and all inflammation subsided within 4 weeks. Both patients had uneventful cataract surgery, were apyrexial, and were generally well. A few possible mechanisms for these episodes are infection, reaction to povidone-iodine or sub-Tenon's anesthetic, or trauma due to the sub-Tenon's cannula.
Mukherji
Subhanjan
S
Registrar Department, Royal Alexandra Hospital, Paisley, Paisley, United Kingdom. subhanjan@doctors.net.uk
Esakowitz
Leonard
L
D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects*; D019162:Anesthetics, Combined / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D005205:Fascia / Q000187:drug effects; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000009:adverse effects; D007249:Inflammation; D008012:Lidocaine / Q000009:adverse effects*; D016727:Orbital Pseudotumor / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011239:Prednisolone / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D005938:Glucocorticoids; D008012:Lidocaine; D011239:Prednisolone; D006821:Hyaluronoglucosaminidase; D002045:Bupivacaine