Posterior segment injury developed after injection of anesthetics on eyelids with needleless jet injection device.
BACKGROUND
Though a needleless jet injection device (NJI device) has advantages over a conventional needle attached syringe for injecting anesthetics, safety of using it for lid surgery is not proved. We report a case of posterior segment injury suspected caused by a NJI device.


METHODS
A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device.


RESULTS
Vitreous and subretinal hemorrhage was found associated with retinal edema adjacent to the optic disc of the right eye and around the inferior temporal arcade of the left eye. Fluorescein angiography revealed choroidal rupture in the both eyes. By 2 months, although the hemorrhage resolved, subretinal fibrosis and chorioretinal atrophy developed. Her vision decreased to 20/60 in the right eye and 20/40 in the left eye.


CONCLUSIONS
The energy generated by the NJI device seemed to have reached the eyeballs to cause the blunt-typed posterior segment injuries. As choroidal rupture may result in a permanent visual loss, the risks associated the off-labeled use of the device for lid surgeries should be awakened.
Lee
Ji Eun
JE
Department of Ophthalmology, College of Medicine, Pusan National University, 1-10, Ami-dong, Seo-gu, Busan, 602-739, South Korea.
Choi
Hee Young
HY
Lee
Jong Soo
JS
Oum
Boo Sup
BS
D000772:Anesthesia, Local / Q000295:instrumentation*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002829:Choroid / Q000293:injuries*; D005131:Eye Injuries / Q000175:diagnosis / Q000209:etiology*; D005143:Eyelids / Q000187:drug effects; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007277:Injections, Jet / Q000009:adverse effects*; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D012421:Rupture; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000209:etiology*
D000779:Anesthetics, Local