| A Case of Descemet's Membrane Detachment during Lidocaine Injection for Hordeolum Incision and Drainage. |
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Bo Ram Kim, Si Yoon Park, Hyung Keun Lee, Kyoung Yul Seo, Eung Kweon Kim, Tae Im Kim |
1The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. TIKIM@yuhs.ac
2Corneal Dystrophy Research Institute, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea. |
| 다래끼제거술 중 리도카인 국소마취제 주입으로 인해 생긴 데스메막분리 1예 |
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김보람1⋅박시윤1⋅이형근1,2⋅서경률1,2⋅김응권1,2⋅김태임1,2 |
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연세대학교 의과대학 안과학교실 시기능개발연구소1, 연세대학교 의과대학 안과학교실 각막이상증연구소2 |
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| Abstract |
PURPOSE
To report a case of Descemet's membrane detachment and corneal edema caused by an iatrogenic corneal perforation created while performing a local anesthetic (lidocaine) injection into the eyelid for a hordeolum incision and a drainage procedure. The detachment resolved after 14% C₃F₈ gas and air injections into the anterior chamber. CASE SUMMARY: An 8-year-old female visited our clinic after the onset of severe pain and decreased visual acuity while receiving a local anesthetic injection into the upper eyelid in preparation for a hordeolum incision and drainage procedure. Corneal optical coherence tomography (OCT) showed Descemet's membrane detachment. Three days after the first visit, the corneal epithelium had entirely healed. However, Descemet's membrane detachment persisted even after three weeks of follow-up. A corneal OCT was repeated after three weeks and showed a partial Descemet's membrane rupture. A more aggressive treatment method was deemed necessary, and gas and air injections into the anterior chamber were performed. After 48 hours, aside from some Descemet's membrane rolling at the site of rupture, overall reattachment of Descemet's membrane was noted. After three months of follow-up, the patient showed a stable corneal state and normalized vision. CONCLUSIONS: Descemet's membrane detachment and rupture resulting from an iatrogenic corneal perforation during an injection of lidocaine to the eyelid led to decreased visual acuity from corneal edema. As a more aggressive treatment method, 14 % C₃F₈ gas and air injections into the anterior chamber were performed and resulted in near complete reattachment of Descemet's membrane's and normalization of the patient's visual acuity. |
| Key Words:
Descemet's membrane rupture;Incision and drainage procedures for hordeolum;Local anesthesia |
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