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May 1988

Blindness as a Complication of Rhinoplasty

Author Affiliations

Bassum, the Netherlands

Arch Otolaryngol Head Neck Surg. 1988;114(5):581. doi:10.1001/archotol.1988.01860170111036

To the Editor.—With interest I read the clinical note by Drs Cheney and Blair1 reporting a case of unilateral blindness following septorhinoplasty. I treated a similar case, fortunately with a more favorable outcome. It concerns a 26-year-old man with a moderate septal deviation. Surgical correction was to be performed using local anesthesia. Following premedication with atropine sulfate and an opiate, local anesthesia was obtained using strips of cotton wool, soaked in tetracaine and xylometazoline, and, subsequently, with a few submucous injections of 1% prilocain with epinephrine 1:100 000. This was administered submucosally in areas 2 and 3 bilaterally, using about 0.5 mL per injection. Following one injection, at the border between areas 2 and 3 and about 2.5 cm from the nasal floor, the patient suddenly reported some pain in his left eye, followed one minute later by a complete loss of vision in that eye. The left

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