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December 1981

Bilateral Visual Loss After Blepharoplasty

Arch Ophthalmol. 1981;99(12):2205. doi:10.1001/archopht.1981.03930021081019

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To the Editor.  —We recently published an article entitled "Bilateral Visual Loss After Blepharoplasty" (Ann Plast Surg 1980;5:288-292) that may be missed by many ophthalmologists. I believe it is important for all surgeons performing cosmetic surgery to be aware of this complication, its cause, and the suggested treatment. Thus, I am writing this letter to bring this tragic case to the attention of all ophthalmologists.

Report of a Case.  —Blindness after blepharoplasty is a well-documented complication. Common to most of these cases is the removal of orbital fat. We saw a patient who was referred to us after undergoing an outpatient blepharoplasty in all four eyelids using lidocaine hydrochloride with epinephrine hydrochloride, with the removal of orbital fat, which resulted in bilateral visual loss. The patient experienced a hypertensive episode during the procedure with a blood pressure of 260/140 mm Hg. There was uncontrolled bleeding, and the lower eyelid incisions

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