Abstract
BACKGROUND—Ocular alkali burns can be associated with a poor visual outcome. The release of collagenases and proteases after the injury leads to corneoscleral melting. The role of topical steroids in such patients is controversial as they have been postulated to exacerbate corneoscleral melting. METHODS—30 patients were reviewed retrospectively after admission to King's College Hospital with alkali burns between 1990 and 1993. All patients were treated with an intense and prolonged regimen of topical steroids and topical and systemic vitamin C. RESULTS—22 patients had mild injuries and eight had severe injuries as estimated by the Roper-Hall grading system. 23 patients were treated with topical steroids for > 10 days and 22 patients were treated with topical vitamin C for more than 10 days. One patient with a severe injury developed corneoscleral melting. CONCLUSION—Prolonged treatment with topical steroids when used in conjunction with topical vitamin C is not associated with corneoscleral melting.
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Selected References
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- Beare J. D. Eye injuries from assault with chemicals. Br J Ophthalmol. 1990 Sep;74(9):514–518. doi: 10.1136/bjo.74.9.514. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Donshik P. C., Berman M. B., Dohlman C. H., Gage J., Rose J. Effect of topical corticosteroids on ulceration in alkali-burned corneas. Arch Ophthalmol. 1978 Nov;96(11):2117–2120. doi: 10.1001/archopht.1978.03910060497024. [DOI] [PubMed] [Google Scholar]
- Pahlitzsch T., Sinha P. The alkali burned cornea: electron microscopical, enzyme histochemical, and biochemical observations. Graefes Arch Clin Exp Ophthalmol. 1985;223(5):278–286. doi: 10.1007/BF02153659. [DOI] [PubMed] [Google Scholar]
- Pfister R. R. Chemical injuries of the eye. Ophthalmology. 1983 Oct;90(10):1246–1253. [PubMed] [Google Scholar]
- Pfister R. R., Haddox J. L., Lank K. M. Citrate or ascorbate/citrate treatment of established corneal ulcers in the alkali-injured rabbit eye. Invest Ophthalmol Vis Sci. 1988 Jul;29(7):1110–1115. [PubMed] [Google Scholar]
- Pfister R. R., Paterson C. A. Ascorbic acid in the treatment of alkali burns of the eye. Ophthalmology. 1980 Oct;87(10):1050–1057. doi: 10.1016/s0161-6420(80)35126-9. [DOI] [PubMed] [Google Scholar]
- Reim M., Bahrke C., Kuckelkorn R., Kuwert T. Investigation of enzyme activities in severe burns of the anterior eye segment. Graefes Arch Clin Exp Ophthalmol. 1993 May;231(5):308–312. doi: 10.1007/BF00919110. [DOI] [PubMed] [Google Scholar]