Ocular surface reconstruction after exposure to high concentrations of antiseptic solutions.

PURPOSE: To report the clinical course in accidental exposure of the cornea to antiseptic solutions in 3 cases.

METHODS

Observational case series. Exposure to 20% chlorhexidine gluconate solution was observed in 2 cases and to 10% benzalkonium chloride solution in 1 case.

RESULTS

Not only superficial damage but also toxicity to corneal endothelial cells leading to corneal edema was observed in all 3 cases. Epithelial transplantation was performed: autologous cultivated limbal epithelial transplantation (auto-CLET), conjunctivolimbal autograft (CLAU), or living-related cultivated limbal epithelial transplantation (lr-CLET). A stable ocular surface was achieved, although exposure to high concentrations of antiseptic solutions caused severe anterior chamber inflammation; cataract and glaucoma developed in 2 cases, requiring further surgical treatment.

CONCLUSIONS

Exposure to high concentrations of antiseptics causes both ocular surface and intraocular damage. Epithelial transplantation enables restoration of a stable ocular surface. However, management of intraocular consequences, including secondary glaucoma and corneal endothelial damage, still remains a challenge in the prognosis of such cases.