Biomaterial Database

Posterior segment injury developed after injection of anesthetics on eyelids with needleless jet injection device. 2007

Ji Eun Lee, and Hee Young Choi, and Jong Soo Lee, and Boo Sup Oum

Department of Ophthalmology, College of Medicine, Pusan National University, 1-10, Ami-dong, Seo-gu, Busan, 602-739, South Korea.

BACKGROUND 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. METHODS A 47-year-old woman presented with decreased visual acuity after regional anesthesia at the lower eyelids with a NJI device. RESULTS 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. CONCLUSIONS 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.

UI	MeSH Term	Description	Entries
D007277	Injections, Jet	The injection of solutions into the skin by compressed air devices so that only the solution pierces the skin.	Jet Injections,Injection, Jet,Jet Injection
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D002829	Choroid	The thin, highly vascular membrane covering most of the posterior of the eye between the RETINA and SCLERA.	Choriocapillaris,Haller Layer,Haller's Layer,Sattler Layer,Sattler's Layer,Choroids
D005131	Eye Injuries	Damage or trauma inflicted to the eye by external means. The concept includes both surface injuries and intraocular injuries.	Injuries, Eye,Eye Injury,Injury, Eye
D005143	Eyelids	Each of the upper and lower folds of SKIN which cover the EYE when closed.	Eyelid
D005260	Female		Females
D005451	Fluorescein Angiography	Visualization of a vascular system after intravenous injection of a fluorescein solution. The images may be photographed or televised. It is used especially in studying the retinal and uveal vasculature.	Fluorescence Angiography,Fundus Fluorescence Photography,Angiography, Fluorescein,Angiography, Fluorescence,Fluorescence Photography, Fundus,Photography, Fundus Fluorescence
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000772	Anesthesia, Local	A blocking of nerve conduction to a specific area by an injection of an anesthetic agent.	Anesthesia, Infiltration,Local Anesthesia,Neural Therapy of Huneke,Huneke Neural Therapy,Infiltration Anesthesia
D000779	Anesthetics, Local	Drugs that block nerve conduction when applied locally to nerve tissue in appropriate concentrations. They act on any part of the nervous system and on every type of nerve fiber. In contact with a nerve trunk, these anesthetics can cause both sensory and motor paralysis in the innervated area. Their action is completely reversible. (From Gilman AG, et. al., Goodman and Gilman's The Pharmacological Basis of Therapeutics, 8th ed) Nearly all local anesthetics act by reducing the tendency of voltage-dependent sodium channels to activate.	Anesthetics, Conduction-Blocking,Conduction-Blocking Anesthetics,Local Anesthetic,Anesthetics, Topical,Anesthetic, Local,Anesthetics, Conduction Blocking,Conduction Blocking Anesthetics,Local Anesthetics,Topical Anesthetics