Angioedema related to the use of hyaluronidase in cataract surgery

PURPOSE: To report a series of cases of angioedema related to the use of hyaluronidase in cataract surgery. DESIGN: Observational case series. METHODS: Three eyes of three patients who had periorbital angioedema after phacoemulsification at the Mayo Clinic, Rochester, Minnesota, between April 2001 and May 2002 were retrospectively skin tested for allergies using the prick technique. RESULTS: Skin testing was positive in all three patients for allergy to hyaluronidase (150 U/cc) and histamine control; and negative for prick control, 2% lidocaine, 1% cyclopentolate, 2.5% neosynephrine, 0.5% proparacaine, 0.3% ofloxacin, and thimerosal. CONCLUSIONS: The use of hyaluronidase in ophthalmic anesthesia injection may cause immediate type hypersensitivity reactions such as angioedema. (C) 2004 by Elsevier Inc. All rights reserved.