title: Complications related to a cosmetic eye-whitening procedure.
abstract: OBJECTIVE
  To report sight-threatening complications following extensive bulbar conjunctival resection and postoperative mitomycin C therapy for cosmetic eye-whitening in the United States.
  
  
  METHODS
  Retrospective noncomparative case series.
  
  
  METHODS
  Multicenter report of 9 patients referred for evaluation and management of complications following bilateral cosmetic eye whitening.
  
  
  RESULTS
  Seventeen eyes of 9 patients underwent cosmetic eye-whitening performed between 2 and 48 months prior to referral to one of the centers. Sixteen of the 17 eyes had persistent conjunctival epithelial defects, with 10 eyes requiring amniotic membrane grafting to facilitate re-epithelialization. Four eyes of 2 patients developed limbal stem cell compromise confirmed with in vivo confocal laser scanning microscopy. One patient developed infectious scleritis and diplopia resulting from Tenon capsule scarring. Another patient developed scleral necrosis, secondary infectious scleritis, and infectious endophthalmitis. This patient subsequently developed noninfectious scleritis that required 3-drug-regimen immunosuppression.
  
  
  CONCLUSIONS
  Severe adverse effects can occur after extensive cosmetic conjunctival resection followed by topical mitomycin C application. Patients and physicians should be aware of the potential sight-threatening complications associated with this eye-whitening procedure.
authors: Cornea Service, Jules Stein Eye Institute, David Geffen School of Medicine, Los Angeles, California.
authors: Rosalind C
authors: RC
authors: Vo
authors: Cornea Service, Jules Stein Eye Institute, David Geffen School of Medicine, Los Angeles, California.
authors: Ksenia
authors: K
authors: Stafeeva
authors: Cornea Service, Jules Stein Eye Institute, David Geffen School of Medicine, Los Angeles, California.
authors: Anthony J
authors: AJ
authors: Aldave
authors: Stulting Research Center, Woolfson Eye Institute, Atlanta, Georgia.
authors: R Doyle
authors: RD
authors: Stulting
authors: Ocular Surface Center, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors: Quianta
authors: Q
authors: Moore
authors: Ocular Surface Center, Department of Ophthalmology, Baylor College of Medicine, Houston, Texas.
authors: Stephen C
authors: SC
authors: Pflugfelder
authors: F.I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California.
authors: Neil C
authors: NC
authors: Chungfat
authors: F.I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California.
authors: Douglas S
authors: DS
authors: Holsclaw
authors: F.I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, California.
authors: Todd P
authors: TP
authors: Margolis
authors: Cornea Service, Jules Stein Eye Institute, David Geffen School of Medicine, Los Angeles, California. Electronic address: deng@jsei.ucla.edu.
authors: Sophie X
authors: SX
authors: Deng
mesh_terms: D000328:Adult; D000477:Alkylating Agents / Q000009:adverse effects; D003228:Conjunctiva / Q000187:drug effects / Q000601:surgery*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000009:adverse effects*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D000477:Alkylating Agents; D016685:Mitomycin