A Case of Corneal Chemical Injury by High-dose Ethanol during Orbital Wall Fracture Repair
10.3341/jkos.2019.60.4.374
- Author:
Jong Young LEE
1
;
Jung Yeol CHOI
;
Jinho JEONG
Author Information
1. Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. dr.jinho.jeong@gmail.com
- Publication Type:Case Report
- Keywords:
Chemical injury;
Cornea;
Endothelial cell loss;
Ethanol-containing antiseptics
- MeSH:
Anti-Bacterial Agents;
Chlorhexidine;
Cornea;
Corneal Injuries;
Corneal Surgery, Laser;
Disinfection;
Edema;
Endothelial Cells;
Ethanol;
Humans;
Male;
Middle Aged;
Ophthalmic Solutions;
Orbit;
Punctures;
Skin;
Steroids
- From:Journal of the Korean Ophthalmological Society
2019;60(4):374-379
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of chemical injury of the cornea caused by high-dose ethanol during orbital wall fracture repair. CASE SUMMARY: A 56-year-old male presented with pain after blowout fracture repair surgery. During the surgery, 2% hexethanol solution (2% chlorhexidine and 72% ethanol mixture), which was used for disinfection of the face, flowed into the left eye. Conjunctival injection in the left limbus, a large corneal epithelial defect, and severe stromal edema were subsequently observed. The patient was treated with topical antibiotics, steroids, and autologous serum eye drops. After 1 week, the corneal epithelial defect was improved, but at the second month of therapy, recurrent corneal erosion with deterioration of the endothelial cell function occurred. Anterior stromal puncture and laser keratectomy were performed. The corneal epithelial defect and erosion improved, but the endothelial cell density was severely decreased. CONCLUSIONS: The 2% hexethanol solution is usually used for preoperative skin disinfection, but it contains a high concentration of ethanol. The surgeon should be aware that high concentrations of ethanol may result in severe corneal damage, including corneal endothelial dysfunction and limbal cell deficiency.
