A Case of Inadvertent Anterior Chamber and Corneal Stromal Injection with Antibiotics during Cataract Operation.
10.3341/kjo.2006.20.4.241
- Author:
Byoung Jin HA
1
;
Sang Hyup LEE
;
Yong Min KIM
;
Hyun Seok KWON
;
Young Kwang CHU
;
Kyoung Yul SEO
Author Information
1. Siloam Eye Hospital, Seoul, Korea. drchu@yahoo.com
- Publication Type:Case Report
- Keywords:
Antibiotics;
Balanced salt solution;
Corneal edema
- MeSH:
Visual Acuity;
Postoperative Complications/prevention & control;
Intraoperative Care/*methods;
Injections;
Humans;
Follow-Up Studies;
Female;
Endophthalmitis/*prevention & control;
Corneal Stroma;
Cataract Extraction/*methods;
Anti-Bacterial Agents/*administration & dosage/therapeutic use;
Anterior Chamber;
Aged
- From:Korean Journal of Ophthalmology
2006;20(4):241-245
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To report a case of inadvertent anterior chamber and cornea stromal injection with high dose antibiotics and steroids during cataract operation. METHODS: During cataract operation on a 78 year-old female patient, high dose gentamicin (20 mg/0.5 ml) and dexamethasone (2 mg/0.5 ml) were inadvertently injected into the anterior chamber and cornea stroma when making cornea edema for sealing of the incision sites. Anterior chamber irrigation with balanced salt solution (BSS) was immediately administered. On postoperative day one, extensive cornea edema was noted, and best-corrected visual acuity was 0.2. Descemet's membrane folds were observed around the corneal incision sites. Topical 5% NaCl and 1% prednisolone were started. RESULTS: Four weeks postoperatively, corneal edema began to reduce significantly. At four months postoperatively, corneal edema fully resolved, and best-corrected visual acuity was 0.8. However, some Descemet's membrane folds still remained, and a decrease in the number of endothelial cells was noted by specular microscope. CONCLUSIONS: In this case involving anterior chamber and cornea stromal injection with high dose antibiotics and steroids, immediate anterior chamber irrigation with balanced salt solution seemed an appropriate management, and the patient's long-term visual acuity appears good. To prevent such mistakes, precise labeling of all solutions and use of different syringe needles should be considered.