J Korean Ophthalmol Soc > Volume 60(4); 2019 > Article
Journal of the Korean Ophthalmological Society 2019;60(4):374-379.
DOI: https://doi.org/10.3341/jkos.2019.60.4.374    Published online April 15, 2019.
A Case of Corneal Chemical Injury by High-dose Ethanol during Orbital Wall Fracture Repair.
Jong Young Lee, Jung Yeol Choi, Jinho Jeong
Department of Ophthalmology, Jeju National University School of Medicine, Jeju, Korea. dr.jinho.jeong@gmail.com
안와골절정복술 시 사용된 고농도 에탄올에 의한 각막화상 1예
이종영⋅최정열⋅정진호
제주대학교 의과대학 안과학교실
Correspondence:  Jinho Jeong,
Email: dr.jinho.jeong@gmail.com
Received: 5 July 2018   • Revised: 27 August 2018   • Accepted: 26 March 2019
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.
Key Words: Chemical injury;Cornea;Endothelial cell loss;Ethanol-containing antiseptics


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