title: Allergic reaction to hyaluronidase after retrobulbar anaesthesia: a case series and review.
abstract: BACKGROUND
  The enzyme hyaluronidase (HA) is an adjunctive in retrobulbar anaesthesia (RA) that is used during ophthalmic surgery to improve the efficacy and speed of nerve blocks. Although uncommon, HA has been shown to be a potential cause of allergic responses.
  
  
  METHODS
  We describe three patients who experienced an allergic reaction to HA following ocular surgery in our department and provide an extensive overview of the literature on HA in RA.
  
  
  CONCLUSIONS
  Although rare and mostly benign, allergy to HA should be included in the differential diagnosis when chemosis, proptosis and restriction of eye movements occur after parabulbar or retrobulbar anaesthesia. The authors feel that the beneficial effect of HA in small volumes of RA warrants its use despite this potential complication.
authors.affiliation: Department of Ophthalmology, University Hospitals Leuven, Campus St Raphaël, Kapucijnenvoer 33, 3000, Leuven, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Delaere
authors.forename: T
authors.initials: T
authors.lastname: Zeyen
authors.forename: B
authors.initials: B
authors.lastname: Foets
authors.forename: J
authors.initials: J
authors.lastname: Van Calster
authors.forename: I
authors.initials: I
authors.lastname: Stalmans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local / Q000009:adverse effects*; D002387:Cataract Extraction; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000009:adverse effects*; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D009915:Orbit; D014057:Tomography, X-Ray Computed
chemical_list: D006821:Hyaluronoglucosaminidase
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