Intraoperative Anaphylaxis during Small Incision Cataract Surgery: A Case Report and Emergency Management Protocol

Abstract

This paper presents a summary of a rare yet serious allergic reaction occurring during cataract surgery in a 78-year-old lady. She underwent small incision cataract surgery with implantation of the posterior camber treatment with the implantation of the lens when, a few minutes after local anaesthetic (lidocaine, bupivacaine, adrenaline, and hyaluronidase) administration, she showed the symptoms of anaphylactic reaction: tachycardia, skin rash, protrusion of the eyelids, and dyspnoea. Adrenaline, together with hydrocortisone, pheniramine, and a bronchodilator, was administered by anesthesiologist on time, and the symptoms reduced in the period of 30 minutes. Her eye surgery was successful, and her vision improved. This case shows the importance of prompt diagnosis of allergic reactions and their correct treatment by emergency procedures. The other theme is the need to conduct allergy tests before surgery and have sufficient training and readiness in eye clinics in order to ensure patient safety.