Acute Corneal Epithelial Detachment During Lid Speculum Placement Prior to Intravitreal Injection in a Diabetic Patient: A Case Report.

Introduction: Diabetic macular edema (DME) is a vision-threatening complication of diabetic retinopathy. Intravitreal anti-VEGF injections offer effective treatment, but they carry a risk of corneal epithelial detachment, particularly in patients who have recently undergone cataract surgery.

Case presentation: A 63-year-old male developed bilateral DME following cataract surgery with intraocular lens implantation. His best-corrected visual acuity (BCVA) was 0.15 in the right eye and 0.5 in the left eye. The patient underwent bilateral intravitreal injections of the anti-VEGF agent conbercept. During preparation for the injection in the left eye, corneal epithelial bleb formation was observed. The patient received corneal patching therapy, with complete epithelial healing observed by day 10 post-injection. This case underscores the need for vigilant corneal monitoring during and after intravitreal injections in diabetic patients with prior cataract surgery.

Conclusion: Close observation of corneal epithelial healing is crucial in diabetic patients receiving intravitreal injections, especially those with a recent history of cataract surgery. Careful pre-injection assessment and vigilant post-injection management are essential to mitigate this potential complication.