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January 27, 1989

Corneal Damage due to Eye Contact With Chlorhexidine Gluconate

JAMA. 1989;261(4):557-558. doi:10.1001/jama.1989.03420040091021

To the Editor.—  Use of chlorhexidine gluconate for preparing a patient's facial skin prior to surgical incision has resulted in irreversible corneal damage in at least four patients. Cases 1 and 2 were reported to the Food and Drug Administration; cases 3 and 4 were reported by Hamed et al.1

Report of Cases.—  Case 1.—A 60-year-old woman was treated with chlorhexidine gluconate on the face prior to transantral ethmoidectomy. Chlorhexidine gluconate got into her eyes, where it remained for one hour. She developed bilateral eye redness, pain, and diminished vision (20/200), due to severe corneal damage. A corneal transplant was performed two months later.

Case 2.—  A 45-year-old woman was treated with chlorhexidine gluconate for presurgical preparation of the face. The length of time the drug remained in the eyes is not known. Corneal injuries resulted in both eyes and remained present at three months' follow-up. Vision in one