A case of inadvertent anterior chamber and corneal stromal injection with antibiotics during cataract operation.
OBJECTIVE
To report a case of inadvertent anterior chamber and cornea stromal injection with high dose antibiotics and steroids during cataract operation.


METHODS
During cataract operation on a 78 year-old female patient, high dose gentamicin (20 mg/0.5 ml) and dexamethasone (2 mg/0.5 ml) were inadvertently injected into the anterior chamber and cornea stroma when making cornea edema for sealing of the incision sites. Anterior chamber irrigation with balanced salt solution (BSS) was immediately administered. On postoperative day one, extensive cornea edema was noted, and best-corrected visual acuity was 0.2. Descemet's membrane folds were observed around the corneal incision sites. Topical 5% NaCl and 1% prednisolone were started.


RESULTS
Four weeks postoperatively, corneal edema began to reduce significantly. At four months postoperatively, corneal edema fully resolved, and best-corrected visual acuity was 0.8. However, some Descemet's membrane folds still remained, and a decrease in the number of endothelial cells was noted by specular microscope.


CONCLUSIONS
In this case involving anterior chamber and cornea stromal injection with high dose antibiotics and steroids, immediate anterior chamber irrigation with balanced salt solution seemed an appropriate management, and the patient's long-term visual acuity appears good. To prevent such mistakes, precise labeling of all solutions and use of different syringe needles should be considered.
Ha
Byoung Jin
BJ
Siloam Eye Hospital, Seoul, Korea.
Lee
Sang Hyup
SH
Kim
Yong Min
YM
Kwon
Hyun Seok
HS
Chu
Young Kwang
YK
Seo
Kyoung Yul
KY
D000368:Aged; D000867:Anterior Chamber; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D002387:Cataract Extraction / Q000379:methods*; D003319:Corneal Stroma; D009877:Endophthalmitis / Q000517:prevention & control*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007430:Intraoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D014792:Visual Acuity
D000900:Anti-Bacterial Agents