P 33Autoinoculation of BepanthenÒ ointment
T. Pfeiler, T. Schmidt
Purpose: To present the case of a 95 years old patient who autoinoculatet BepanthenÒ ointment which was surgically removed from the anterior chamber.
Case report: The patient had a self inflicted injury of his left eye caused by a clothes peg. He used BepanthenÒ ointment to relief the foreign body sensation. Both eyes showed a primary open angel glaucoma and a corneal dystrophy of Fuchs type. Several operations had been performed before on both eyes, the left eye showed a trabeculectomy, a keratoplasty and was pseudophacic.
Findings and Operation: At admissison visual acuity of the left eye was hand movements and localisation of light. Apart from a distinct corneal edema the temporal inferior quadrant of the keratoplasty was ruptured and showed a steplike figure with fluoreszein-enrichment. No leakage was seen. Tension was 36 mm Hg. The anterior chamber was deep and featured except for a strong fibrinous reaction several cordlike and spherical white structures of BepanthenÒ ointment. Intraoperative we saw that theese were not only impacted in the angle of the anterior chamber and iris, but also behind the iris. After extensive lavage and removal of the ointment through the gap, the wound was closed by 10/0 nylon sutures. Postsurgical treatment consisted of systemic and topic antibiotic therapy as well as topical use of steroids.
Conclusions: Apparently the keratoplsty was ruptured by the injury followed by direct intraocular application of BepanthenÒ ointment. At dismission the tension was regulated without therapy, visual acuity was 1/20.
Augenklinik und -poliklinik rechts der Isar der Technischen Universität München, Ismaningerstr. 22, D - 81675 München