Current status of emergency treatment of chemical eye burns in workplaces

Chemical eye burns present an avoidable,but frequent,occupational injury with potentially detrimental consequences for the quality of life and occupational rehabilitation of the injured.A periodical review of guidelines is required to assure the optimal emergency management.We reviewed the literature with emphasis on current German guidelines,primarily MEDLINE.If the crucial first-line measure,the injury prevention has failed and an eye burn has been sustained,the immediate and copious rinsing of the eye is the pivotal emergency treatment modality.Whereas the immediacy and sufficiency of the emergency rinsing are largely unanimous,there is an ongoing debate about the benefits and risks of specific rinsing solutions,and regular updates on guidelines and recommendations for the emergency treatment are warranted.The easiest and readily available rinsing solution is tap water,which fulfils the crucial criteria conveniently in most industrialized countries:purity,sterility,and neutral p H.Other rinsing solutions are proposing higher osmolality to stabilize the physiological p H,because of their superior buffering capacity.However,there is no compelling evidence for a substantial benefit,and some reports suggest that there could be unwanted side effects.In combination with the substantially increased expenditure and a more complex handling procedure,currently a general recommendation of any other solution than tap water is not warranted.

Effect of amnion membrane transplantation on corneal neovascularization in 10 patients with alkali burn

By observing clinical cases, we studied the curative effect of amnion membrane transplantation on decreasing corneal neovascularization (CNV). It was a non-randomized retrospective case-control study. Among 17 cases (21 eyes) of third-degree alkali burns from 2007 to 2010, 10 cases (12 eyes) were performed with amnion membrane transplantation operation, and others were not. Amnion membrane transplantation was performed at the 3rd day after burn in the treatment group. Areas of CNV in double groups were measured at the 14th day and 60th day after burn. Area of CNV in the treatment group was (66.207±7.251)mm2 at the 14th day after burn, and was 18.27% lower than that in the control group. Area of CNV in the treatment group was (120.046±13.812)mm2 at the 60th day after burn, and was 11.35% lower than that in the control group. There was both statistical significance (P<0.05). Amnion membrane transplantation operation can inhibit the growth of corneal neovascularization induced by alkali burn.

Transplantation of corneal stem cells cultured on amniotic membrane for corneal burn: experimental and clinical study

OBJECTIVE: To investigate the proliferation and differentiation of cultured corneal stem cells and determine the effect of corneal stem cells cultured on amniotic membranes on the limbal area for treating corneal burns. METHODS: The proliferation and differentiation of corneal stem cells in vitro had been examined using colony-forming efficiency and immunohistochemistry. The stem cells had been cultured on amniotic membranes and transplanted to the limbal area for treating corneal burns. RESULTS: Corneal stem cells had a high proliferation capacity in primary and first passage, cytokeratin 3 was not expressed in primary culture but partly in first passage. The stem cells could proliferate to form cell layer on an amniotic membrane. When transplanted, stem cells could survive on limbus. After transplantation, ocular inflammation resolved, the cornea re-epithelialized, the stromal opacity reduced, the superficial neovascularity was lessened and the conjunctival fornix re-established. CONCLUSIONS: Ocular surface conditions could be improved by allograft of corneal stem cells cultured on amniotic membranes.