Reparative and antioxidant therapy of chemical eye burns

Цель работы — изучить эффективность комплексного лечения химических ожогов глаз с использованием фотодинамической терапии (ФДТ) и инстилляций виксипина по данным импрессионной цитологии (ИЦ) и биохимическим показателям слезной жидкости (СЖ). Материал и методы. Обследовано и пролечено 104 пациента (146 глаз) в возрасте от 18 до 72 лет с ожогом глаз I, II и III степени. К стандартному лечению добавлена ФДТ (I группа, 35 пациентов, 48 глаз) и сочетание ФДТ с инстилляциями препарата Виксипин (Солофарм, Россия) — глазные капли (II группа, 32 пациента, 46 глаз). Группу сравнения (стандартная терапия) составили 37 пациентов (52 глаза). Эффективность лечения оценивалась с помощью ИЦ и биохимических анализов СЖ на 7-й день лечения.Результаты. Исходные данные ИЦ свидетельствуют о смещении показателей цитограммы в сторону ядерных структур, во всех группах ядерно-цитоплазматическое отношение (ЯЦО) составило в среднем 0,068. В результате лечения у пациентов основных (I и II) групп определялось преобладание репаративных процессов в эпителиальных клетках, при этом ЯЦО увеличилось до 0,290 ± 0,010 в I и 0,320 ± 0,014 во II группе, что превышало в 3,9 и 4,5 раза соответственно аналогичные показатели в группе сравнения. Уровень стабильных метаболитов оксида азота в СЖ при добавлении виксипина достоверно снизился по отношению к значениям до лечения в 1,59 раза и составил 4,21 ± 0,32 мк моль/л. Данный показатель оказался в 1,23 раза ниже, чем в I группе, и приблизился к нормативным показателям (3,52 ± 0,23), превышая их в 1,19 раза. Заключение. Добавление ФДТ и виксипина к стандартному лечению химических ожогов глаз усиливает регенерацию ожоговой поверхности, нормализует показатели анти

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 pH. Other rinsing solutions are proposing higher osmolality to stabilize the physiological pH, 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.

Severe corneal burn due to the accidental application of salicylic acid packed in a plastic dropper bottle

Eye burns due to the accidental application of pharmacological or nonpharmacological substances packaged in plastic dropper bottles have been described for more than three decades and continue to occur. These burns can cause potentially serious corneal injuries. We report the case of a patient who mistakenly applied salicylic acid to the right eye after confusing it with an eye lubricant, which caused him a severe corneal burn. Fortunately, after aggressive medical and surgical management (including oxygen therapy and amniotic membrane grafting), the visual results were good.We suggest conducting educational campaigns and taking legislative measures in our country to avoid packaging corrosive substances in this type of dropper bottle to reduce the risk of accidental burns.

Dynamics of cytological parameters of the conjunctiva in the course of a complex treatment of eye burns using a low-intensity laser radiation

Purpose: A cytological assessment of the effectiveness of eye burns complex treatment using low-intensity infrared laser radiation (LILR) was performed. Material and methods. 42 patients (64 eyes) with eye burns of different etiology and severity were examined. For the patients of the main group (21 patients, 30 eyes) low-intensity infrared laser radiation was added to the traditional treatment methods. Results. Decrease in the number of basophils and the amount of exudation during the inflammatory process indicated the suppression of the initial forms of inflammatory mediators – histamine and serotonin; the disappearance of leukocytes and restoration of the cytoplasm structure and epithelial nuclei was the result of the prostaglandins and leukotrienes suppression by LILR. An increase in the nuclear cytoplasmic ratio (NCR) was the result of the metabolic processes activation and the increase of their regenerative ability. Conclusion. Therefore, the use of LIRL is considered to be an effective method of the eye burn treatment since it triggers and prolongs the effect of the primary therapy.