title: Two episodes of anaphylaxis following exposure to hydroxypropyl methylcellulose during cataract surgery.
abstract: We report a case of immediate severe anaphylaxis to hydroxypropyl methylcellulose (HPMC) on 2 separate occasions during cataract surgery in a 71-year-old patient. Skin prick tests were positive for HPMC, a constituent of Ocucoat and Xylocaine gel, which were administered intraocularly during surgery. Skin prick tests were also positive for methylcellulose. Based on symptoms and clinical signs of anaphylaxis following 2 separate cataract operations together with positive prick tests to HPMC, HPMC is the most plausible cause of the reactions. The patient has since had uneventful surgery for a detached retina avoiding HPMC. This case stresses the importance of considering all medication given to patients as possible causes of an anaphylactic reaction.
  
  
  BACKGROUND
  No author has a financial or proprietary interest in any material or method mentioned.
authors.affiliation: Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Sofie J
authors.initials: SJ
authors.lastname: Munk
authors.forename: Steffen
authors.initials: S
authors.lastname: Heegaard
authors.forename: Holger
authors.initials: H
authors.lastname: Mosbech
authors.forename: Lene H
authors.initials: LH
authors.lastname: Garvey
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced*; D002387:Cataract Extraction; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D065347:Hypromellose Derivatives; D008297:Male; D008747:Methylcellulose / Q000009:adverse effects / Q000031:analogs & derivatives*; D009883:Ophthalmic Solutions / Q000009:adverse effects*; D012008:Recurrence; D012882:Skin Tests
chemical_list: D009883:Ophthalmic Solutions; D065347:Hypromellose Derivatives; D008747:Methylcellulose