Dangerous Cosmetic Eye-Whitening Procedure

PLASTIC SURGERY PRACTICE
Code Red: PSP investigates dangerous cosmetic eye-whitening procedure
Published on February 2, 2015
By Denise Mann
Cosmetic eye-whitening procedures are designed to make the eyes look brighter, whiter, and less red, but they may do more harm than good, experts warn.
The procedure typically involves inhibiting blood vessel growth to the eyes by excising the conjunctiva and then applying topical mitomycin C or anti-VEGF meds such as Avastin® (bevacizumab) during surgery and sometimes afterward. The cost is between $3,000 to $5,000 per eye.
This cosmetic procedure has a high risk of serious potential complications.
“The majority of ophthalmologists will not do this 
procedure to whiten the eye, as the complications such 
as chronic dry eye, scleral melt and diplopia don’t 
merit the benefits.” Said Susan Fromer, MD
Risks include poor healing, conjunctival epithelial defects, stem cell deficiency, scleral necrosis/necrotizing scleritis, infectious scleritis, infectious endophthalmitis, diplopia, and scleral calcific plaques, he says. “It’s not only the seriousness of the complications, but their frequency.”
In a retrospective study published in a 2013 issue of American Journal of Ophthalmology, the complication rate in more than 1,700 patients was 83% with 56% considered serious.
“This is a modification of a procedure most ophthalmologists do for pterygium, a benign eye growth,” explains Susan Fromer, MD, an ophthalmologist at Lenox Hill Hospital in New York City. “The 
problem lies in the way it is being done, exposing the patients to unacceptable complications at a future date.”
“The majority of ophthalmologists will not do this procedure to whiten the eye, as the complications such as chronic dry eye, scleral melt, and diplopia don’t merit the benefits,” she says. Patients with chronic eye redness may already have dry eye syndrome and are already prone to delayed wound healing after these procedures, Dr. Fromer explains.
“Even though eye whitening has been portrayed as a simple and effective surgery for treating chronic red eyes, the literature shows that the inherent risks of disrupting the normal physiology of the eye surface outweigh the benefits of this elective surgery at this time,” she says.
Instead, “It is more important to have a comprehensive eye exam to find out the underlying etiology of chronic redness in both eyes. Most of the time, chronic eye redness may be due to dry eye syndrome, ocular allergies, or other disorders affecting the front part of the eye.” The surgery does have a role in treating dilated blood vessels or racial pigments, she says.