Postoperative eyelid infection in a patient taking etanercept

Postoperative eyelid infections are a rare complication of eyelid surgery. The authors present a case of an eyelid infection occurring within the first week following surgery in a patient taking etanercept--a biologic anti-TNF-α agent used in the treatment of rheumatoid arthritis. The authors urge caution regarding the use of steroid/antibiotic combination ointments and systemic steroids in patients undergoing elective eyelid surgery who are on such medications. Perioperative discontinuation of etanercept in consultation with the prescribing physician may also be considered. Eyelid infections following eyelid surgeries such as blepharoplasty and ptosis correction are uncommon.( 1 , 2 ) A review of a large series of blepharoplasty procedures estimated the rate of postoperative infection at 0.2%.( 3 ) However, patients who are relatively immunosuppressed may be at a higher risk of developing skin and eyelid infections. We present a case of postoperative infection in a patient who was taking etanercept (Enbrel, Immunex Corporation, Thousand Oaks, CA) for rheumatoid arthritis.