Bilateral Corneal Necrosis Associated With Long-Term Use Of Skin Whitening Products: A Surgical Challenge
Published 2026 - 44th Congress of the ESCRS
Reference: PP25.07 | Type: Poster | DOI: 10.82333/pksq-z841
Authors: Dr Hibat Allah Eddaoui* 1 , Dr Youness Bouhafra 1 , Dr Boutaina Bousellam 1 , Dr Nour Alsaket 1 , A/Prof. Nabiha Benchekroun 1 , A/Prof. mohammed belmekki 1
1ophtalmology,Cheikh zaid international hospital,rabat,Morocco
Purpose
Corneal necrosis is a severe and rare condition that can lead to profound visual loss. Toxic exposure related to chronic use of cosmetic or skin whitening products has been reported as a potential risk factor for ocular surface toxicity. We report a case of bilateral corneal necrosis managed surgically with therapeutic keratoplasty.
Setting
We present the case of a 44-year-old female with no significant medical history except long-term use of skin whitening products. The patient developed bilateral corneal ulcers several months before presentation, which failed to improve despite medical treatment, leading to emergency referral.
Initial ophthalmic examination revealed bilateral light perception-only visual acuity.
Methods
Slit-lamp examination showed total corneal opacification with iris and ciliary body prolapse in both eyes, preventing further ocular assessment. Systemic examination revealed facial vitiligo. B-scan ultrasonography confirmed an attached retina with a preserved posterior segment. The etiological workup was negative.
After multidisciplinary discussion, two therapeutic strategies were considered: evisceration or globe-preserving reconstructive surgery
Results
The decision was made to attempt therapeutic keratoplasty combined with anterior vitrectomy and cataract management.
Surgery of the left eye was technically challenging and included removal of a dense pre-iris membrane with iridoplasty, intracapsular extraction of a luxated total cataract, wide anterior vitrectomy, and limbus-to-limbus corneal grafting.
Postoperative follow-up showed significant pain relief and visual improvement from light perception to counting fingers at close distance with optical correction (+10 diopters at 2 meters). The patient was satisfied with the functional outcome but was informed about potential long-term complications
Conclusions
Therapeutic penetrating keratoplasty combined with anterior segment reconstruction may represent a viable globe-preserving strategy in severe corneal necrosis. Early diagnosis, cessation of toxic exposure, and timely surgical intervention are essential to improve anatomical and functional outcomes.