ABSTRACT
El uso de anestésicos locales para la realización de procedimientos odontológicos es una práctica ampliamente extendida que puede causar efectos adversos. Sin embargo, muy infrecuentemente puede causar complicaciones oculares como diplopía, ptosis, visión borrosa, miosis, disminución de la agudeza visual o amaurosis. Presentamos un caso de un paciente varón de 26 años que se presentó a la consulta por una disminución de la agudeza visual en su ojo derecho 48h después de una intervención odontológica del lado ipsilateral, logrando una recuperación de la misma en los 6 meses posteriores, sin tratamiento alguno. Diferentes teorías que justifiquen la aparición de complicaciones oculares como consecuencia de esta clase de procedimientos han sido propuestas en la literatura. En nuestro caso, una inyección intravenosa inadvertida habría sido la causa posible del hecho (AU)
The use of intra-oral local anaesthetics for dental procedures is a widely extended practice that may cause side effects. As such, in rare cases it may cause ocular complications such as diplopia, ptosis, blurry vision, miosis, vision loss, or amaurosis. (Most of them are transient, recovering after several hours or days). A case is presented of a 26 year-old male patient who had visual impairment in the right eye 2 days after a dental procedure was performed. Six months later he had a complete restoration of the previous visual acuity, despite the fact that he had not received any treatment. Several ways have been proposed in the literature that may explain the appearance of ocular complications following these kinds of procedures. In this case, inadvertent intravenous injection is believed to have been the cause (AU)
Subject(s)
Humans , Male , Adult , Anesthesia, Local/adverse effects , Anesthetics/adverse effects , Diplopia/etiology , Vision Disorders/etiology , Tooth Extraction/adverse effects , Visual Acuity/drug effectsABSTRACT
The use of intra-oral local anaesthetics for dental procedures is a widely extended practice that may cause side effects. As such, in rare cases it may cause ocular complications such as diplopia, ptosis, blurry vision, miosis, vision loss, or amaurosis. (Most of them are transient, recovering after several hours or days). A case is presented of a 26 year-old male patient who had visual impairment in the right eye 2 days after a dental procedure was performed. Six months later he had a complete restoration of the previous visual acuity, despite the fact that he had not received any treatment. Several ways have been proposed in the literature that may explain the appearance of ocular complications following these kinds of procedures. In this case, inadvertent intravenous injection is believed to have been the cause.
Subject(s)
Anesthesia, Local , Vision Disorders , Adult , Anesthetics, Local/adverse effects , Blindness , Diplopia/etiology , Humans , Male , Vision Disorders/etiologyABSTRACT
The use of intra-oral local anaesthetics for dental procedures is a widely extended practice that may cause side effects. As such, in rare cases it may cause ocular complications such as diplopia, ptosis, blurry vision, miosis, vision loss, or amaurosis. (Most of them are transient, recovering after several hours or days). A case is presented of a 26 year-old male patient who had visual impairment in the right eye 2 days after a dental procedure was performed. Six months later he had a complete restoration of the previous visual acuity, despite the fact that he had not received any treatment. Several ways have been proposed in the literature that may explain the appearance of ocular complications following these kinds of procedures. In this case, inadvertent intravenous injection is believed to have been the cause.
ABSTRACT
PURPOSE: To determine the central corneal thickness after administration of the anti-glaucomatous medications latanoprost 0.005% or dorzolamide 2%, as assessed in rabbits which have had total corneal thickness autografts. METHODS: A bilateral total corneal thickness autograft was performed in ten rabbits. One rabbit was excluded from the subsequent study in which the antiglaucomatous medication was started two months post-operatively. Latanoprost 0.005% was instilled once per day into the right eye, whereas the left eyes were treated with dorzolamide 2% twice a day. The eyes were examined by biomicroscopy and ultrasound pachymetry immediately prior to commencement, and 4, 10, 17 and 27 weeks after starting the anti-glaucomatous treatment. In each instance three assessments of the central corneal thickness in each eye were made. At the end of the study, the influence of time and treatment on the corneal thickness was analyzed using a generalized linear model for repeated measurements. All penetrating keratoplasties were performed by the same surgeon (C.H.P). RESULTS: Treatment with dorzolamide resulted in corneal edema and a significant increase in central corneal thickness, whereas the treatment with latanoprost resulted in neither corneal edema nor corneal thickness changes. CONCLUSIONS: Dorzolamide, when instilled into the eyes of rabbits with corneal autografts, could have a negative effect on the graft, impairing the endothelial function through inhibition of the ionic pump. This effect could cause graft failure, which may be able to be defined with ultrasound pachimetry.
Subject(s)
Antihypertensive Agents/pharmacology , Cornea/drug effects , Cornea/pathology , Corneal Transplantation , Prostaglandins F, Synthetic/pharmacology , Sulfonamides/pharmacology , Thiophenes/pharmacology , Animals , Latanoprost , RabbitsABSTRACT
BACKGROUND: Anterior chamber miotic solutions are widely used in ophthalmic surgery to induce pupillary contraction. We investigated whether the acetylcholine, carbachol, or mannitol present in perfusing solutions can affect corneal endothelial function. METHODS: Freshly dissected deepithelized rabbit corneas were mounted in a Dikstein-Maurice chamber at 36 degrees C. The endothelial sides were perfused with six solutions: (A) 55 mM (1%) acetylcholine Cl plus modified balanced salts; (B) control for A, with acetylcholine Cl replaced by sucrose; (C) 0.55 mM (0.01%) carbachol Cl plus balanced salts; (D) balanced salts solution (BS; control for C); (E) 3% mannitol plus modified balanced salts; and (F) modified balanced salts (control for E, with mannitol replaced by sucrose). Corneal thickness was followed for 3 h in each experiment. The effect of solution E did not differ from that of solution F. RESULTS: The carbachol-containing solution produced a small increase in corneal thickness compared to the control solution, while the acetylcholine-containing solution resulted in corneal thickness lower than that in control preparations. CONCLUSION: From these data, acetylcholine is harmless to the endothelium, and may actually stimulate its fluid pump mechanism. Carbachol, on the other hand, appears to have a detrimental effect.
Subject(s)
Acetylcholine/pharmacology , Carbachol/pharmacology , Diuretics, Osmotic/pharmacology , Endothelium, Corneal/physiology , Mannitol/pharmacology , Miotics/pharmacology , Animals , Biological Transport, Active/drug effects , Endothelium, Corneal/cytology , Endothelium, Corneal/drug effects , In Vitro Techniques , Male , Perfusion , RabbitsABSTRACT
BACKGROUND: Anterior chamber miotic solutions are widely used during anterior chamber surgery. We examined the effects of solutions containing miotic agents such as carbachol and/or acetylcholine on corneal endothelial pumping activity. METHODS: We monitored, in vitro, the transendothelial electrical potential difference of isolated rabbit corneal endothelial preparations. As controls, we used solutions without miotics. RESULTS: We found that a solution containing 55 mM acetylcholine and minimal amounts of salts (Miochol E) maintains transendothelial electrical potential difference some 30% above control levels for up to 4 h. Two other solutions, one including balanced salts and 0.55 mM carbachol (Miostat), the other a mixture of 0.19 mM carbachol and 55 mM acetylcholine plus minimal salts, are adequate to maintain the potential difference at control levels. Lastly, a solution with acetylcholine but without any salts (Miochol) greatly decreases the potential difference, to 30% of the control level, in 100 min. CONCLUSION: Our results indicate that: (1) 55 mM (1%) acetylcholine stimulates the endothelial electrical potential difference; (2) addition of 0.19 mM (0.003%) carbachol negates the stimulatory effect of acetylcholine; and (3) absence of electrolytes severely depresses the endothelial electrical activity.