Course and Outcome of Accidental Sodium Hydroxide Ocular Injury

详细信息    查看全文

• 作者：Namrata Sharma ; Digvijay Singh ; Amit Sobti ; Prakashch ; Agarwal ; Thirumurthy Velp ; ian ; Jeewan S. Titiyal ; Supriyo Ghose
• 刊名：American Journal of Ophthalmology
• 出版年：2012
• 出版时间：October, 2012
• 年：2012
• 卷：154
• 期：4
• 页码：740-749.e2
• 全文大小：2117 K

文摘

| Figures/TablesFigures/Tables | ReferencesReferences

Purpose

To evaluate the course and outcome of patients with accidental ocular alkali burns.

Design

Prospective, interventional case series.

Methods

Study of a cohort of 16 patients (31 eyes) who sustained concomitant accidental sodium hydroxide ocular burns and received appropriate treatment at a tertiary care eye hospital in India. The patients were followed up for 1 year, and parameters including best-corrected visual acuity, epithelial defect area, conjunctival and limbal involvement, and injury-related complications were evaluated.

Results

Severe sodium hydroxide exposure of a mean duration of 12 ¡À 2.5 minutes and delay in specialist eye care caused moderate to severe injury (grade II, 19 % [n = 6]; grade III, 19 % [n = 6]; grade IV, 10 % [n = 3]; and grade VI, 52 % [n = 16]). Median best-corrected visual acuity at presentation was 1.0 logarithm of the minimal angle of resolution (logMAR) units (range, 0.3 to 1.9 logMAR units), and at 1 year, it was 1.0 logMAR units (range, 0 to 1.9 logMAR units; P = .121). The median initial epithelial defect was 100 mm² (range, 18 to 121 mm²), which healed in all eyes by 3.5 months. Initial median limbal involvement was 12 clock hours (range, 3 to 12 clock hours), resulting in a residual limbal stem cell deficiency of 6 clock hours (range, 0 to 12 clock hours) at 1 year. Most common complications were glaucoma and cataract. Corneal ulcers developed in 2 eyes, and keratolimbal graft was performed in 1 patient. Grade VI injuries had significantly worse outcome than the lower-grade injuries.

Conclusions

The course and outcome of ocular alkali burns depends on effective first aid (including a thorough eyewash), age, initial grade of injury, response to treatment, prevention of secondary infection, and control of glaucoma. Despite appropriate treatment, these eyes responded poorly and carried a guarded visual prognosis.