Inadvertent intracorneal injection of local anesthetic during lid surgery.
OBJECTIVE
To report a case of inadvertent intracorneal injection of anesthetic agents during lid anesthesia and corneal penetration without full-thickness perforation.


METHODS
Case report.


RESULTS
Corneal edema with acute loss of vision was noted. The patient was treated with topical, antibiotic, cycloplegic, hyperosmotic agent and lubricant. While the edema slowly subsided, a loss in endothelial cell count was noted.


CONCLUSIONS
The effects of intracorneal injection of lignocaine, bupivacaine, and its preservatives have not previously been reported in the literature. A lower postinjection endothelial cell count and associated clinical features in our case indicate that endothelial toxicity occurred. This potential complication should be kept in mind with necessary precautions taken during injection of the eyelid, particularly in cases with preexisting lid laxity.
Ghosh
Sambuddha
S
Regional Institute of Ophthalmology, Medical College, Kolkata, West Bengal, India. sambuddhaghosh@gmail.com
Mukhopadhyay
Suman
S
Mukhopadhyay
Subhalakshmi
S
Roy
Rupam
R
Dutta
Himadri
H
D000368:Aged; D000772:Anesthesia, Local / Q000009:adverse effects; D019162:Anesthetics, Combined / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects; D002452:Cell Count; D015715:Corneal Edema / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D055954:Corneal Endothelial Cell Loss / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D065306:Corneal Injuries; D003319:Corneal Stroma / Q000187:drug effects; D004774:Entropion / Q000601:surgery; D005131:Eye Injuries / Q000209:etiology; D005143:Eyelids / Q000601:surgery; D006801:Humans; D008012:Lidocaine / Q000009:adverse effects; D008297:Male; D016602:Needlestick Injuries / Q000209:etiology*; D014945:Wound Healing; D014949:Wounds, Nonpenetrating / Q000209:etiology*
D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine