J Korean Ophthalmol Soc.  1998 Aug;39(8):1897-1902.

A Case of Severe Neurological Damage and Blindness after Infection of Lidocaine for Cataract Operation

Affiliations
  • 1Department of Ophthalmology, College of Medicine, Chung-Ang University, Seoul, Korea.

Abstract

At the present time, lidocaine is commonly used in ophthalmic surgery as a local anesthetic. Although it is safer than general anesthesia, visionthreatening and even life-threatening side effect can occur rarely. We report one case of visual loss combined with severe neurologic damage after local injection of lidocaine. Fifty-year-old male patient underwent phacoemulsification and IOL transscleral implantation with unplanned anterior vitrectomy after Nadbath-Ellis akinesia and retrobulbar anesthesia with lidocaine with 1:100,000 epinephrine. After operation, the patient had visual loss, facial palsy, total ophthalmoplegia, severe proptosis and submandibular swelling. There were no evidences of eyeball perforation, retrobulbar hemorrhage, and direct nerve injury. Although the mechanism of nerve injury is not well explainable, we suggest lidocaine toxic reaction. To our knowledge, This is the first reported case in the literature. We report this case with available literature review.

Keyword

Lidocaine; Nerve damage; Retrobulbar anesthesia

MeSH Terms

Anesthesia
Anesthesia, General
Blindness*
Cataract*
Epinephrine
Exophthalmos
Facial Paralysis
Humans
Lidocaine*
Male
Ophthalmoplegia
Phacoemulsification
Retrobulbar Hemorrhage
Vitrectomy
Epinephrine
Lidocaine
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