title: Toxic endothelial cell destruction syndrome after intraocular lens repositioning with intracameral epinephrine.
abstract: A 66-year-old Chinese man developed corneal endothelial decompensation after intraocular lens (IOL) repositioning using intracameral epinephrine was performed. The presentation was compatible with toxic endothelial cell destruction syndrome, which is caused by prolonged, direct exposure of the corneal endothelium to relatively high concentrations of intracameral epinephrine. Despite its effective and immediate mydriatic effect, intracameral epinephrine is not recommended for intraoperative mydriasis in procedures such as IOL repositioning or secondary IOL implantation in which minimal irrigating solution is used.
authors.affiliation: Department of Ophthalmology, United Christian Hospital, Kowloon, Hong Kong SAR, China. jeffpong@gmail.com
authors.forename: Jeffrey C F
authors.initials: JC
authors.lastname: Pong
authors.forename: Wilson W T
authors.initials: WW
authors.lastname: Tang
authors.forename: Jimmy S M
authors.initials: JS
authors.lastname: Lai
mesh_terms: D000368:Aged; D000867:Anterior Chamber / Q000187:drug effects; D003316:Corneal Diseases / Q000139:chemically induced*; D004728:Endothelium, Corneal / Q000187:drug effects*; D004837:Epinephrine / Q000009:adverse effects*; D005548:Foreign-Body Migration / Q000601:surgery*; D006801:Humans; D007910:Lenses, Intraocular; D008297:Male; D009184:Mydriatics / Q000009:adverse effects*; D012086:Reoperation; D013577:Syndrome
chemical_list: D009184:Mydriatics; D004837:Epinephrine