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Orbital cellulits following cataract surgery under peribulbar anaesthesia

Title: Orbital cellulits following cataract surgery under peribulbar anaesthesia
Authors: Chandoshi Mukherjee; Arijit Mitra; Bushra Mushtaq
Source: GMS Ophthalmology Cases – An Open Access Journal, ISSN 2193-1496 ; urn:issn: 2193-1496 ; citationNote: Mukherjee C, Mitra A, Mushtaq B. Orbital cellulits following cataract surgery under peribulbar anaesthesia. GMS Ophthalmol Cases. 2015;5:Doc02.DOI:10.3205/oc000024URN: urn:nbn:de:0183-oc0000248
Publisher Information: German Medical Science GMS Publishing House, Düsseldorf
Publication Year: 2015
Subject Terms: ddc:610; orbital cellulitis; peribulbar anaesthesia; complication
Description: Introduction: Orbital cellulits following cataract surgery is extremely rare. We describe a case of orbital and facial cellulitis that occurred after routine cataract operation with peribulbar anaesthesia. There were no preoperative systemic or ocular risk factors for postoperative infection. Case description: An 89-year-old man presented to eye casualty, the day after he underwent an uneventful phacoemulsification and posterior chamber lens implantation in the left eye under peribulabr anaesthesia, with soreness, swelling and reduced visual acuity (6/18) in the operated eye. On initial presentation periorbital swelling was noted, the eye was minimally tender, intraocular pressure was raised at 28 mHg and fundoscopy was limited due to a hazy cornea. The patient was discharged on topical medication with a diagnosis of allergic reaction to postoperative drops.The following day, the patient re-presented with worsening orbital swelling involving the left cheek. Ocular findings remained unchanged. CT scan revealed left orbit soft tissue swelling and a locule of air medial to the medial rectus. There were no signs of sinus infection or periosteal inflammation. A diagnosis of left orbital and facial cellulitis was made and the patient was treated with intravenous antibiotics.Discussion: Our patient did not have any predisposing risk factors, therefore most likely cause of cellulitis is surgical trauma during administration of the peribulbar block. This case illustrates the need for adequate skin preparation before the administration of peribulbar anaesthesia and minimal tissue trauma during the procedure.
Document Type: article in journal/newspaper
Language: English
Relation: Varma D, Metcalfe TW. Orbital cellulitis after peribulbar anaesthesia for cataract surgery. Eye (Lond). 2003 Jan;17(1):105-6. DOI:10.1038/sj.eye.6700238; Hofbauer JD, Gordon LK, Palmer J. Acute orbital cellulitis after peribulbar injection. Am J Ophthalmol. 1994 Sep 15;118(3):391-2. DOI:10.1016/S0002-9394(14)72965-4; Kimbrough BO, Young AB, Modica LA. Orbital cellulitis and cavernous sinus thrombosis after cataract extraction and lens implantation. Ann Ophthalmol. 1992 Aug;24(8):313-7.; Sharma V, Benger R, Wechsler AW, Kaufman G, Burfitt-Williams GC. Orbital cellulitis following cataract surgery. Clin Experiment Ophthalmol. 2005 Aug;33(4):434-5. DOI:10.1111/j.1442-9071.2005.01046.x; Kumar V, Saunders D. Orbital cellulitis after phacoemulsification and intraocular lens implantation. J Cataract Refract Surg. 2004 Apr;30(4):918-20. DOI:10.1016/j.jcrs.2003.11.026; Kanski JJ. Clinical Ophthalmology. A systematic approach. 6th edition. Edinburgh, New York: Butterworth Heinemann; 1999. p. 175-7.; https://series.publisso.de/en/journals/oc/volume5/oc000024; https://doi.org/10.3205/oc000024; https://series.publisso.de/en/publisso_gold/export/pdf/article/599/oc000024.pdf
DOI: 10.3205/oc000024
Availability: https://series.publisso.de/en/journals/oc/volume5/oc000024; https://series.publisso.de/en/publisso_gold/export/pdf/article/599/oc000024.pdf; https://doi.org/10.3205/oc000024; https://nbn-resolving.de/urn:nbn:de:0183-oc0000248
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.D03A8ABA
Database: BASE