Orbital compartment syndrome caused by intraorbital bacitracin ointment after endoscopic sinus surgery

Am J Ophthalmol. 2000 Sep;130(3):376-8. doi: 10.1016/s0002-9394(00)00557-2.

Abstract

Purpose: To present an unusual case of orbital compartment syndrome after endoscopic sinus surgery.

Methods: Case report.

Results: Acute proptosis, chemosis, decreased vision, and ophthalmoplegia were found immediately after endoscopic sinus surgery. Ophthalmologic evaluation showed a tense orbit, and intraocular pressure increased to 54 mm Hg. Treatment was initiated and the intraocular pressure dropped. Computed tomography (CT) revealed the presence of bacitracin ointment in the orbit.

Conclusion: Ophthalmic complications after sinus surgery are well identified. Postoperative orbital compartment syndrome may be caused by retrobulbar hemorrhage, edema, air (emphysema), or foreign material. In this case, the findings were caused by inadvertent injection of bacitracin ointment into the orbit.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Infective Agents, Local / adverse effects*
  • Bacitracin / adverse effects*
  • Compartment Syndromes / chemically induced*
  • Compartment Syndromes / diagnostic imaging
  • Endoscopy*
  • Exophthalmos / chemically induced
  • Exophthalmos / diagnostic imaging
  • Female
  • Humans
  • Ointments
  • Ophthalmoplegia / chemically induced
  • Ophthalmoplegia / diagnostic imaging
  • Orbital Diseases / chemically induced*
  • Orbital Diseases / diagnostic imaging
  • Paranasal Sinus Diseases / surgery*
  • Tomography, X-Ray Computed
  • Vision Disorders / chemically induced
  • Vision Disorders / diagnostic imaging

Substances

  • Anti-Infective Agents, Local
  • Ointments
  • Bacitracin