Subconjunctival injection of tetracycline 2% for chronic bulbar chemosis after transcutaneous four-eyelid blepharoplasty.

A 51-year-old white woman had an 18-month history of unilateral chronic bulbar chemosis after 4-eyelid cosmetic blepharoplasty. Tetracycline 2% was injected subconjunctivally in the area of the chemosis. After 2 injections over a period of 6 months, the chemosis resolved completely. At final follow-up 9 years later, the patient remained free of chemosis. Two other patients with unilateral chronic chemosis of unknown cause were similarly treated with tetracycline 2% subconjunctival injections. In the first patient, chemosis had been present before an upper eyelid blepharoplasty. After one injection with tetracycline 2%, the chemosis resolved completely and remained absent at final follow-up 8 years later. The second patient reported a 10-year history of chronic chemosis. He had never had blepharoplasty. Two injections with tetracycline 2% within an interval of 6 months were given. At final follow-up 4 years later, mild residual chemosis was present.