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Summary
Accidental intraocular lidocaine injection caused temporary pupil and vision issues in patients. While most recovered fully, one experienced a permanent visual field defect, indicating potential risks of this anesthetic in the eye.
Area of Science:
- Ophthalmology
- Anesthesiology
- Neuroscience
Background:
- Intraocular injections of anesthetics like lidocaine can occur inadvertently.
- Understanding the ocular effects of lidocaine is crucial for patient safety and management.
Purpose of the Study:
- To investigate the clinical effects of inadvertent intraocular lidocaine injection in human patients.
- To evaluate the impact of intraocular lidocaine on retinal and pupillary function using an animal model.
Main Methods:
- Case reports of three patients with inadvertent intraocular lidocaine injection.
- Animal model studies involving intraocular lidocaine administration.
- Electrophysiological (electroretinogram) and histological (light and electron microscopy) assessments.
Main Results:
- In patients, lidocaine caused immediate pupil dilation, paralysis, and reduced visual acuity.
- Full recovery of retinal and pupillary function was observed in two patients within 16 hours.
- One patient sustained a permanent visual field defect.
- Animal models showed temporary pupil paralysis and extinguished electroretinogram b-waves.
- Histological examination revealed no retinal damage beyond the injection site.
Conclusions:
- Intraocular lidocaine can cause significant, though often temporary, visual and pupillary dysfunction.
- While recovery is common, permanent visual field defects are a potential risk.
- Animal studies support the transient nature of lidocaine's effects on retinal function.