Severe Corneal Burn From Inadvertent Colorado Needle Electrocautery Injury During Blepharoplasty

Eyelid surgeries, such as blepharoplasty, ptosis repair, and reconstruction, are performed for functional and cosmetic purposes but carry risks, including infection, hematoma, malposition, and corneal injury. Corneal damage may result from mechanical trauma, desiccation, chemical exposure, or thermal burns from electrosurgical instruments like diathermy or electrocautery. Among these, iatrogenic corneal injuries are a significant concern, particularly when thermal devices are used.

Academic Tertiary Center Eye Institute

We present a case of severe corneal burn during upper eyelid blepharoplasty. A 59-year-old patient sustained an inadvertent electrocautery injury to the right cornea from a Colorado needle. She developed extensive corneal epithelial defects, deep erosion, thinning, conjunctival hyperemia, and photophobia. Immediate tarsorrhaphy was performed, and treatment included topical antibiotics, steroids, oral Vitamin C and doxycycline, and serum eye drops. Over four months, epithelial healing progressed, and the burn trough gradually filled with fibrotic tissue, preventing perforation.

Corneal injuries from Colorado needle electrocautery in eyelid surgery can cause severe complications if not promptly identified and treated. This case emphasizes the importance of meticulous surgical technique, proper corneal protection, and awareness of the thermal risks associated with diathermy to prevent vision-threatening outcomes