Inadvertent ocular perforation during lid anesthesia for hordeolum removal.
OBJECTIVE
Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal.


METHODS
A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous.


RESULTS
Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection.


CONCLUSIONS
Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.
Kim
Jun-Heon
JH
Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea.
Yang
Sun Mo
SM
Kim
Hyo Myung
HM
Oh
Jaeryung
J
D000328:Adult; D000772:Anesthesia, Local / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage; D002387:Cataract Extraction; D065306:Corneal Injuries; D003937:Diagnosis, Differential; D015807:Eye Injuries, Penetrating / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D005141:Eyelid Diseases / Q000601:surgery*; D005143:Eyelids; D005260:Female; D005500:Follow-Up Studies; D006726:Hordeolum / Q000601:surgery*; D006801:Humans; D007267:Injections / Q000009:adverse effects; D007903:Lens Capsule, Crystalline / Q000293:injuries; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage
D000779:Anesthetics, Local; D008012:Lidocaine