title: Ocular surface reconstruction after exposure to high concentrations of antiseptic solutions.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan. shigeyasuchika@kankakuki.go.jp
authors.forename: Chika
authors.initials: C
authors.lastname: Shigeyasu
authors.forename: Jun
authors.initials: J
authors.lastname: Shimazaki
mesh_terms: D000293:Adolescent; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D001548:Benzalkonium Compounds / Q000009:adverse effects*; D002057:Burns, Chemical / Q000601:surgery*; D002710:Chlorhexidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D003316:Corneal Diseases / Q000139:chemically induced / Q000601:surgery*; D019573:Epithelium, Corneal / Q000637:transplantation*; D005126:Eye Burns / Q000139:chemically induced / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019300:Medical Errors; D008875:Middle Aged; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D000891:Anti-Infective Agents, Local; D001548:Benzalkonium Compounds; C010882:chlorhexidine gluconate; D002710:Chlorhexidine