Blindness after cosmetic blepharoplasty: case report

Medina, Flávio Mac Cord; Filho, Paulo de Tarso Ponte Pierre; Freitas, Héverton Barbosa de; Rodrigues, Fabrício Kafury Pereira; Caldato, Roberto

doi:10.1590/s0004-27492005000500024

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…This can be caused either by pulling on the fat pedicles, by the use of vasopressor agents, or by action of vasoactive agents released from extravasated blood. [ 9 ] Robbe's study indicated that anoxaemia (caused by increased tissue metabolism and acidosis), not ischaemia, is the primary mechanism of optic nerve dysfunction following blepharoplasty. Epinephrine can cause both conditions, but anoxaemia does not occur when ornipressin is used instead.…”

Section: Discussion and C Onclusionmentioning

confidence: 99%

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

Mommaerts

Kelen

2021

Annals of Maxillofacial Surgery

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Rationale: Surgeons should be aware of the risk of vision loss associated with blepharoplasty. Patient Concerns: All patients complained of decreased vision, redness and/or pain after blepharoplasty using only local anaesthesia containing epinephrine. Diagnosis: Diagnosis of angle-closure glaucoma (ACG) was made clinically (decreased visual acuity (VA), increased intraocular pressure and a mid-dilated pupil) and through examination (slit lamp examination and dynamic gonioscopy revealed corneal oedema and a shallow anterior chamber respectively). Perioperative posterior ischaemic optic neuropathy (PION) was a diagnosis of exclusion based on the relative afferent pupil defect. Treatment: ACG was treated medically (intravenous [IV] mannitol and topic antiglaucoma medication or oral acetazolamide) and surgically (YAG iridotomy and an additional cataract extraction with trabeculectomy in one patient). PION was treated with IV methylprednisolone. Outcome: Patients with ACG fully recovered. Patients with PION improved clinically, but presented with a pale optic disc and an optic nerve-related visual field defect. Take-Away Lesson: Surgeons should intervene quickly to minimize the chance of permanent vision loss.

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Section: Discussion and C Onclusionmentioning

confidence: 99%

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

Mommaerts

Kelen

2021

Annals of Maxillofacial Surgery

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“…Several studies have documented blindness after injection of local anesthesia in the facial area [1][2][3][4][5][6][7]. The most commonly reported causes of this complication are occlusion of the ophthalmic artery or central retinal artery [6,7].…”

Section: Introductionmentioning

confidence: 99%

Temporary blindness caused by corneal edema after a local anesthetic injection in the eyebrow region: a case report

Hong

Kang

et al. 2022

Arch Craniofac Surg

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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.

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Blepharoplasty

Butani¹

2011

Evidence-Based Procedural Dermatology

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Blindness after cosmetic blepharoplasty: case report

Cited by 4 publications

References 14 publications

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

Visual Loss after Cosmetic Blepharoplasty Using Local Anaesthesia Containing Epinephrine - A Case Series

Temporary blindness caused by corneal edema after a local anesthetic injection in the eyebrow region: a case report

Blepharoplasty

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