Hong Jung Hyun, Jo Yeon Ji, Kang Taewoo, Park Heeseung, Kim Kyoung Eun, Lee Jae Woo, Bae Seong Hwan
Departments of Plastic and Reconstructive Surgery, Pusan National University School of Medicine, Busan, Korea.
Departments of Ophthalmology, Pusan National University School of Medicine, Busan, Korea.
Arch Craniofac Surg. 2022 Aug;23(4):183-186. doi: 10.7181/acfs.2022.00843. Epub 2022 Aug 20.
Plastic surgery around the eyes is usually performed under local anesthesia, using a mixture of lidocaine and epinephrine. Blindness is a rare but devastating complication after the injection of local anesthesia in this region. Most cases reported to date have been caused by occlusion of the ophthalmic artery or central retinal artery. In this case report, however, we present a highly unusual case of blindness caused by corneal edema after a local anesthetic injection. A patient visited the emergency room with a laceration on the eyebrow, and local anesthesia was injected before suturing. Immediately after the injection, severe corneal edema developed, making it impossible to observe the structures in the anterior chamber in detail or check the light reflex and visual acuity of the naked eye. An antibiotic (moxifloxacin hydrochloride) and high-concentration steroid eyedrops were promptly applied. High-concentration steroids were also administered orally. On day 13 post-injury, the visual acuity of the naked eye improved to 1.0, and no recurrence of corneal lesions was observed. Although the cause of corneal edema after the local injection could not be conclusively identified, we hope that this report will help raise clinicians' awareness of this complication and appropriate treatment methods.
眼部整形手术通常在局部麻醉下进行，使用利多卡因和肾上腺素的混合剂。失明是该区域局部麻醉注射后一种罕见但极具破坏性的并发症。迄今为止报道的大多数病例是由眼动脉或视网膜中央动脉阻塞引起的。然而，在本病例报告中，我们呈现了一例局部麻醉注射后因角膜水肿导致失明的极不寻常病例。一名患者因眉部裂伤就诊于急诊室，缝合前进行了局部麻醉注射。注射后立即出现严重角膜水肿，无法详细观察前房结构或检查裸眼的光反射和视力。立即应用了抗生素（盐酸莫西沙星）和高浓度类固醇眼药水。还口服了高浓度类固醇。受伤后第13天，裸眼视力提高到1.0，未观察到角膜病变复发。尽管局部注射后角膜水肿的原因无法最终确定，但我们希望本报告将有助于提高临床医生对这种并发症及适当治疗方法的认识。
