J Korean Ophthalmol Soc > Volume 60(10); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(10):994-998.
DOI: https://doi.org/10.3341/jkos.2019.60.10.994    Published online October 15, 2019.
Corneal Stromal Edema during Lidocaine Injection for Blepharoplasty.
Sung Yeon Jun, Yeon Jung Choi, Young Joo Cho
Hangil Eye Hospital, Incheon, Korea. alive1120@naver.com
성형수술 중 각막기질 내 리도카인 국소마취제 주입으로 인해 생긴 각막부종
전성연 · 최연정 · 조영주
한길안과병원
Correspondence:  YoungJoo Cho, MD
Email: alive1120@naver.com
Received: 4 April 2019   • Revised: 14 May 2019   • Accepted: 24 September 2019
Abstract
PURPOSE
To report a case of corneal edema caused by an iatrogenic lidocaine injection into the corneal stroma created while performing a local anesthetic (lidocaine) injection into the eyelid for a blepharoplasty procedure. CASE SUMMARY: A 15-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection in the upper blepharon for a blepharoplasty procedure. At the first clinical visit, visual acuity was hand motion and an accurate anterior chamber examination was difficult because of corneal edema. The Seidel test was negative. On corneal optical coherence tomography, the corneal thickness was 1,580 µm without any sign of Descemet's membrane detachment. We prescribed 5% NaCl four times a day and prednisolone acetate eight times a day. On the next day after injury, the corneal edema was significantly improved (central corneal thickness: 660 µm), and Descemet's membrane detachment was still not observed. One week after injury, the naïve visual acuity was 20/20, the central corneal thickness was 560 µm, and the endothelial cell count was 3,260 cells/cm². Three weeks after injury, the corneal edema was fully resolved and only slight temporal corneal haziness remained. After 2 months, the cornea was clear without any subjective discomfort. CONCLUSIONS: Corneal edema without Descemet's membrane detachment can be resolved spontaneously without aggressive treatment such as gas or air injection. However, endothelial cell count and corneal opacity need to be monitored on follow up exam. This clinical experience suggests that severe corneal edema in anterior stromal layer could be spontaneously resolved without severe complication.
Key Words: Blepharoplasty;Corneal edema;Local anesthesia


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