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EC number: 200-927-2
CAS number: 76-03-9
The patient is a 47-year-old woman who was undergoing 35% TCA peel of
the face for dyschromia and a desire for skin rejuvenation. The face was
first cleansed with a gentle cleanser, alcohol, and acetone. Petrolatum
was applied to periocular, perinasal, and perioral mucosal surfaces to
protect against seepage into these areas. The patient was supine and
urged to keep her eyes tightly closed throughout. The 35% TCA was
applied with cotton to the entire face for 2 minutes until erythema and
frosting were evident. Ice water was then used to soothe and comfort the
patient’s face. Shortly thereafter she began to complain of irritation
and burning of the left eye, which was noted to have excessive tearing
and marked conjunctival injection. Her eye was immediately flushed with
100 cc of an isotonic, buffered, sterile eye irrigating solution.
Ophthalmology was called, and the patient was advised to use double
antibiotic ophthalmic ointment, ibuprofen 400 mg by mouth three times a
day, and cool compresses until she could be seen the following morning.
Ophthalmologic evaluation ultimately revealed conjunctival infection and
mild inferior superficial punctate keratitis involving 25% of the
cornea. With continued supportive care there was rapid improvement and
complete corneal healing within 72 hours. There were no lasting effects.
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