Posterior segment injury developed after injection of anesthetics on eyelids with needleless jet injection device.

Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie
Ji Eun LeeBoo Sup Oum

Abstract

Though a needleless jet injection device (NJI device) has advantages over a conventional needle attached syringe for injecting anesthetics, safety of using it for lid surgery is not proved. We report a case of posterior segment injury suspected caused by a NJI device. A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device. Vitreous and subretinal hemorrhage was found associated with retinal edema adjacent to the optic disc of the right eye and around the inferior temporal arcade of the left eye. Fluorescein angiography revealed choroidal rupture in the both eyes. By 2 months, although the hemorrhage resolved, subretinal fibrosis and chorioretinal atrophy developed. Her vision decreased to 20/60 in the right eye and 20/40 in the left eye. The energy generated by the NJI device seemed to have reached the eyeballs to cause the blunt-typed posterior segment injuries. As choroidal rupture may result in a permanent visual loss, the risks associated the off-labeled use of the device for lid surgeries should be awakened.

References

Apr 1, 1979·The Journal of Trauma·V D Salanga, J F Hahn
Apr 1, 1990·The British Journal of Ophthalmology·C M Wood, J Richardson
Nov 20, 1998·Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons·J BennettJ Condry
Nov 1, 1963·American Journal of Ophthalmology·J R WOLTER

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Citations

Jul 23, 2008·Archives of Facial Plastic Surgery·M Reza VagefiRichard L Anderson
May 12, 2010·Cornea·Sambuddha GhoshHimadri Dutta
Feb 13, 2015·Ophthalmic Plastic and Reconstructive Surgery·Leon RafailovRoman Shinder

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