A 68-year-old male with a history of idiopathic choroidal polypoid vasculopathy in the left eye (LE), treated with five sessions of photodynamic therapy, a transpupilary nasal thermotherapy and seven injections of belux.
The protocol of our center for intravitreal injections consists of multiple instillations of lidocaine to 5% povidone-iophane applied to the periocular skin and conjunctival sac in the forefoot.
In the operating room, we applied a swab soaked with 5% lidocaine on the site where the injection is to be performed, keeping it for about 30 seconds, we immediately instilled another drop of povidone and intraví.
Finally, we instilled a drop of ofloxacin eye drop.
After this treatment, pannus was evident in the superior quadrant of the cornea with an epitheliopathy affecting the central area and with a small epithelial defect.
An impression cytology of the limbal conjunctiva was performed and the result showed a partial loss of goblet cells without keratinization. The diagnosis was limbal insufficiency secondary to multiple intravitreal injections in the nasal quadrant.
Despite intensive treatment with luteinizing agent and 50% autologous serum, the area of epitheliopathy was increasing, observing a pattern of conjunctival epithelialization with irregular epithelium in the upper quadrant, being normal.
At this time, the visual acuity (VA) of the left eye was 0.08 and it was decided to surgically intervene by ipsilateral limbal autoinjection.
Figure 3 shows the biomicroscopic aspect on the third postoperative day.
At the last follow-up visit 2 months after surgery, VA was 0.09, a more transparent cornea, an intact epithelium and a marked improvement in ocular surface alteration.
