Intraoperative pulmonary oedema in a child following systemic absorption of phenylephrine eyedrops

Area of Science:

• Ophthalmology
• Cardiology
• Pharmacology

Background:

• Phenylephrine is commonly used topically in ophthalmic surgery to achieve pupillary dilation.
• Understanding potential systemic absorption and adverse effects is crucial for patient safety.

Observation:

• A pediatric patient experienced cardiac arrhythmias, severe hypertension, and pulmonary edema after intraoperative topical phenylephrine administration.
• This case highlights a potential severe adverse event associated with ocular phenylephrine.

Findings:

• Systemic absorption of topical ocular phenylephrine was identified as the likely cause of the severe cardiovascular and pulmonary complications.
• The study suggests that the drug's systemic uptake can lead to life-threatening conditions.

Implications:

• Ophthalmic surgeons should be aware of the risks of systemic phenylephrine absorption in pediatric patients.
• Strategies to reduce systemic absorption during ophthalmic procedures should be explored and implemented to enhance patient safety.