Plasma fibroblast skin tightening treatment resulting in bilateral chemical eye injury secondary to EMLA cream: a case report

Abstract

Background: Plasma fibroblast skin tightening treatment is a relatively novel and growing minimally invasive aesthetic skin procedure. The treatment claims to rejuvenate skin by improving facial lines, wrinkles and skin pigmentation associated with photo-ageing. The skin is often anaesthetised prior to the procedure with topical creams such as EMLA (Eutectic mixture of local anaesthetics). We present the first case of bilateral chemical eye injury following plasma fibroblast skin tightening treatment secondary to EMLA cream. EMLA cream was inadvertently administered to both eyes in preparation for the treatment. Case presentation: A patient was referred from the emergency department to a tertiary ophthalmology centre with bilateral exquisite eye pain, inability to open the eyes, photosensitivity and reduced vision. She underwent cosmetic plasma fibroblast skin tightening treatment at her local salon four hours earlier. She was found to have bilateral alkali chemical eye injuries with significant diffuse corneal epithelial loss. The injury was thought to be caused by inadvertent ocular exposure to EMLA cream, which was used in preparation for the plasma fibroblast skin tightening treatment. She was treated with topical antibiotics and achieved satisfactory recovery. Conclusion: This case report highlights a possible complication following plasma fibroblast skin tightening treatment. We lay emphasis on the importance identifying chemical injury and recommend that medication attention should be sought if there is any concern.

Bilateral Thermal Keratopathy Due to Plasma Skin Regeneration

“…Despite numerous reports of ocular complications from cosmetic lasers, only one previous case of ocular issues from PSR has been reported. 7 Patel et al 7 described bilateral keratitis that occurred immediately after PSR to the eyelids and periorbital skin. They noted an elevated ocular pH of 7 to 8 on presentation, and thus diagnosed the patient with chemical keratitis from alkaline topical anesthetic cream used for the procedure.…”

“…6 However, the safety profile of PSR, while generally favorable, warrants caution due to the inherent vulnerability of periocular tissues to thermal injury and potential corneal toxicity from adjunctive topical anesthetics. 7 We report a case of bilateral thermal keratopathy post-PSR, emphasizing the need for stringent ocular protection strategies during treatment. Consent was obtained and all data collection was HIPAA compliant and adheres to the tenets of the Declaration of Helsinki.…”

Analysis of fibroblast pen usage amongst TikTok social media users

“…There have been reports of serious, potentially long‐term adverse effects following fibroblast pen use. One patient experienced bilateral chemical eye injury caused by a topical anesthetic cream administered inadvertently to both eyes in preparation for a plasma pen procedure at a salon 7,9,10,11 . Although numerous risks have been associated with the fibroblast pen, only 6.5% of the posts mentioned the potential for adverse reactions or advised against the procedure being performed.…”

“…One patient experienced bilateral chemical eye injury caused by a topical anesthetic cream administered inadvertently to both eyes in preparation for a plasma pen procedure at a salon. 7,9,10,11 Although numerous risks have been associated with the fibroblast pen, only 6.5% of the posts mentioned the potential for adverse reactions or advised against the procedure being performed. These adverse effects are likely to increase in frequency when plasma pens are used by improperly trained individuals.…”