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KMID : 0360220190600100994
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Journal of the Korean Ophthalmological Society
2019 Volume.60 No. 10 p.994 ~ p.998
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Corneal Stromal Edema during Lidocaine Injection for Blepharoplasty
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Jun Sung-Yeon
Choi Yeon-Jung
Cho Young-Joo
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Abstract
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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 naive 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.
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KEYWORD
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Blepharoplasty, Corneal edema, Local anesthesia
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