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Park, Choi, Han, and Yang: A Case of Iatrogenic Horner's Syndrome after Video-Thoracoscopic Surgery for Primary Pneumothorax
Case Report
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(1): 157-160.

Published online: 16 January 2012

DOI: https://doi.org/10.3341/jkos.2012.53.1.157

A Case of Iatrogenic Horner's Syndrome after Video-Thoracoscopic Surgery for Primary Pneumothorax

Byung Gun Park, MD1, Jae Won Choi, MD1, Il Yong Han, MD, PhD2, Jae Wook Yang, MD, PhD1

1Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

2Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Jae Wook Yang, MD, PhD. Department of Ophthalmology, Busan Paik Hospital, #633-165 Gaeguem-dong, Busanjin-gu, Busan 614-735, Korea. Tel: 82-51-890-6016, Fax: 82-51-890-6329, eyeyang@inje.ac.kr

Received 28 March 2011       Accepted 12 November 2011

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To report a case of iatrogenic Horner's syndrome after video-thoracoscopic surgery for primary pneumothorax.

Case summary

An 18-year-old man with ptosis in the right eye was referred to our clinic. The patient had undergone wedge resection via video-thoracoscopic surgery for primary pneumothorax three weeks previously. On ocular examination, the palpebral fissure width was 7 mm in the right lid and 8 mm in the left lid, the marginal reflex distance 1 (MRD 1) was 2 mm in the right lid and 3 mm in the left lid, and the bilateral levator muscle function was good. Anisocoria was present, and pupil size in a dark room was 2.5 mm in the right eye and 4 mm in the left eye. The patient complained of facial anhidrosis on the right side of the face.

Conclusions

Although iatrogenic Horner's syndrome is rare complication of video-thoracoscopic surgery for primary pneumothorax, diagnosis after surgery of the thoracic cavity should be made carefully.

Keywords: Horner's syndrome, Iatrogenic, Video thoracoscopic surgery

Figures and Tables

Figure 1
Photographs of an 18-year-old man who underwent chest tube insertion into the right thoracic cavity. (A) Photograph showing 1 mm of right upper eyelid ptosis and anisocoria. (B) Right upper eyelid ptosis and miosis improved after instilling 1% phenylephrine.
jkos-53-157-g001
Figure 2
Chest X-ray showing that tip of chest tube is positioned at T5 level in thoracic caivity. The multiple clips and resection lines for apical lung bullectomy are noted on both sided upper lobes.
jkos-53-157-g002
Figure 3
Photograph of 1 week after mullerectomy. Ptosis is improved by mullerectomy 4 months after the symptom developed.
jkos-53-157-g003

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