J Korean Ophthalmol Soc.  2012 Jan;53(1):157-160. 10.3341/jkos.2012.53.1.157.

A Case of Iatrogenic Horner's Syndrome after Video-Thoracoscopic Surgery for Primary Pneumothorax

• Park BG
• Choi JW
• Han IY
• Yang JW

• KMID: 2215259
• DOI: http://doi.org/10.3341/jkos.2012.53.1.157

Abstract

PURPOSE
To report a case of iatrogenic Horner's syndrome after video-thoracoscopic surgery for primary pneumothorax.
CASE SUMMARY
An 18-year-old man with ptosis in the right eye was referred to our clinic. The patient had undergone wedge resection via video-thoracoscopic surgery for primary pneumothorax three weeks previously. On ocular examination, the palpebral fissure width was 7 mm in the right lid and 8 mm in the left lid, the marginal reflex distance 1 (MRD 1) was 2 mm in the right lid and 3 mm in the left lid, and the bilateral levator muscle function was good. Anisocoria was present, and pupil size in a dark room was 2.5 mm in the right eye and 4 mm in the left eye. The patient complained of facial anhidrosis on the right side of the face.
CONCLUSIONS
Although iatrogenic Horner's syndrome is rare complication of video-thoracoscopic surgery for primary pneumothorax, diagnosis after surgery of the thoracic cavity should be made carefully.

Keyword

Horner's syndrome; Iatrogenic; Video thoracoscopic surgery

MeSH Terms

Adolescent
Anisocoria
Eye
Horner Syndrome
Humans
Hypohidrosis
Muscles
Pneumothorax
Pupil
Reflex
Thoracic Cavity

Figure

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  Figure 1 Photographs of an 18-year-old man who underwent chest tube insertion into the right thoracic cavity. (A) Photograph showing 1 mm of right upper eyelid ptosis and anisocoria. (B) Right upper eyelid ptosis and miosis improved after instilling 1% phenylephrine.

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  Figure 2 Chest X-ray showing that tip of chest tube is positioned at T5 level in thoracic caivity. The multiple clips and resection lines for apical lung bullectomy are noted on both sided upper lobes.

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  Figure 3 Photograph of 1 week after mullerectomy. Ptosis is improved by mullerectomy 4 months after the symptom developed.

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