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Hibiclens keratopathy. A clinicopathologic case report
G A Varley1, D M Meisler, S C Benes
1Department of Ophthalmology, Cleveland Clinic Foundation, Ohio 44195-5024.
Cornea
|October 1, 1990
Summary
Ocular exposure to Hibiclens, an antiseptic, caused severe corneal damage in a patient undergoing oral surgery. The damage included epithelial edema, bullous keratopathy, and endothelial cell loss, necessitating a corneal transplant.
Area of Science:
- Ophthalmology
- Corneal Disease
- Antiseptic Toxicity
Background:
- Preoperative facial preparation with antiseptics is common in surgical procedures.
- Hibiclens (chlorhexidine gluconate) is a widely used broad-spectrum antiseptic.
- Ocular surface complications following facial antisepsis are a potential concern.
Observation:
- A 39-year-old woman presented with acute painful red eye post-oral surgery.
- Facial preparation involved the use of Hibiclens prior to the procedure.
- Corneal changes, including edema and bullous keratopathy, developed and worsened over time.
Findings:
- Microscopic examination revealed epithelial edema, loss of keratocytes, thickened Descemet's membrane, and endothelial cell damage.
- The corneal pathology progressed significantly, leading to the need for penetrating keratoplasty.
- Histopathological analysis confirmed severe corneal injury consistent with chemical exposure.
Implications:
- This case highlights the potential for severe corneal toxicity from accidental ocular exposure to Hibiclens.
- Ophthalmologists and surgeons should be aware of this risk and implement protective measures during facial antisepsis.
- Further research may be warranted to understand the mechanism of Hibiclens-induced corneal damage and prevention strategies.
