Korean J Ophthalmol.  2006 Sep;20(3):199-200. 10.3341/kjo.2006.20.3.199.

Inadvertent Ocular Perforation during Lid Anesthesia for Hordeolum Removal

• Kim JH
• Yang SM
• Kim HM
• Oh J

• KMID: 754581
• DOI: http://doi.org/10.3341/kjo.2006.20.3.199

Abstract

PURPOSE: Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal. METHODS: A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous. RESULTS: Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection. CONCLUSIONS: Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.

Keyword

Hordeolum; Intracameral lidocaine; Lid anesthesia; Ocular perforation

MeSH Terms

Lidocaine/administration & dosage
Lens Implantation, Intraocular
Lens Capsule, Crystalline/injuries
Injections/adverse effects
Humans
Hordeolum/*surgery
Follow-Up Studies
Female
Eyelids
Eyelid Diseases/*surgery
Eye Injuries, Penetrating/diagnosis/*etiology/surgery
Diagnosis, Differential
Cornea/injuries
Cataract Extraction
Anesthetics, Local/administration & dosage
Anesthesia, Local/*adverse effects
Adult

Figure

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  Fig. 1 (A) Swelling of the left upper lid due to a hordeolum. (B) The anterior lens capsule was ruptured and the lens cortex was extruded into the anterior chamber with a penetrating corneal wound at the 10 o'clock mid-peripheral cornea.

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