ASSESSMENT OF VISUAL PROGNOSIS IN PATIENTS WITH OCULAR BURNS: A CROSSSECTIONAL STUDY

Introduction: Ocular burns are ophthalmic emergencies due to their visual morbidity. The extent of ocular surface involvement at the time of presentation is critically associated with visual outcome. Comprehensive ocular examination and prompt management is needed to optimize visual outcome. Objective: This study aims to evaluate the epidemiological trends, clinical features of patients with ocular burns and to determine their relationship with visual outcome. Methods:This prospective, cross-sectional study was conducted on 96 consecutive in-patients who were admitted in the Department of Plastic surgery and Burns in our hospital and sought opinion for ocular burns, irrespective of age and sex. The main outcome measures evaluated were clinical features of ocular burns and prognostic factors associated with visual impairment. Results: In our study, the mean age (S.D.) of patients was 32.83+/- 18.70 years with both males and females equally affected. The most common mode of injury was thermal injury due to domestic accidents (88.5%). 74% of patients had bilateral ocular presentation. Lid burns (42.2%) and lid edema (41.1%) were the most common ocular findings. About 5.2% of eyes showed corneal involvement. About 14 eyes (7.3%) had severe ocular complications among which one eye developed phthisis bulbi. 20 eyes (16.1%) had visual acuity of less than 6/60 causing visual morbidity. In multivariate logistic regression analysis, corneal involvement (p<0.001) and ocular complications (p=0.011) had a significant association with visual impairment. Conclusion:Corneal involvement and ocular complications are less common in facial burns due to Bell's phenomenon and protective blink reflex. However, both factors had a significant influence on visual outcome contributing to visual prognosis. Early intervention and adequate management will lead to favorable visual outcome.

Efficiency of topical application of regenerants and reparents containing group B vitamins in patients with post-burn symblepharon

Ocular burns can lead to complex anatomic disorders and dysfunctions of the ocular surface, as well as palpebral conjunctiva and fornixes, resulting in permanent decrease in basal tear production in long-term period. Some patients need surgery to treat symblepharon and restore eyelids position, conjunctival fornixes and corneal transparency. Nonetheless, as a rule, it is impossible to resolve symptoms of dry eye due to loss of tear-producing elements. Severe decrease of tear production causes significant discomfort for such patients and enforce keratopathy even in good cosmetic result after surgery. To provide the most optimal results on the all steps of the rehabilitation for the patients with ocular burns, it is worth to add cornea reparants and artificial tears containing group B vitamins. On the basis of a clinical case was showed efficiency of topical application of regenerants and reparents containing group B vitamins in patients with post-burn symblepharon. A cornea epithelization was enhanced and improved tear film stability (tear break-up time changed from 1 to 3 seconds). Moreover, such treatment also resulted in discomfort correction and better visual acuity (change from 0.1 to 0.4). Keywords: ocular burn, artificial tears, lubricants, dexpanthenol, pantothenic acid, B5, cyanocobalamin, B12, keratopathy, dry eye syndrome. For citation: Gushсhina M.B., Afanasyeva D.S. Efficiency of topical application of regenerants and reparents containing group B vitamins in patients with post-burn symblepharon. Russian Journal of Clinical Ophthalmology. 2021;21(4):253–257 (in Russ.). DOI: 10.32364/2311-7729- 2021-21-4-253-257.

A Systematic Review on Airbag-Induced Burns

Airbags significantly reduce fatalities and injuries in automobile crashes, but they have been found to be associated with burns. Specifically, airbags can cause burns through thermal or chemical mechanisms and commonly affect the arms, hands, face, and eyes. While most airbag-induced burns are minor, some may cause unfavorable outcomes. Our study aimed to systematically review airbag-induced burns to assess etiology, type, and treatment of these injuries. A systematic review of case reports pertaining to airbag-induced cutaneous and ocular burns was conducted. Data reviewed included type/location of burns, severity of burn, total number of patients, treatment, complications, and outcome after treatment. We identified 21 case reports that met our inclusion criteria with a total of 24 patients reported in the studies. Of the studies identified, 38% were chemical burns and 25% were thermal burns. Most commonly the upper extremities were burned in 42% of cases, followed by eyes (25%) and face (21%). Most burns identified were superficial partial thickness (58%). Treatment outcomes were good for cutaneous burns, with 95% healing without complication. However, ocular injuries lead to permanent impaired eye function in 71% of cases. In our systematic review, we highlighted the common risk factors, prognosis, and treatment for thermal, chemical, and ocular burns. Airbag-induced burns have a relatively good prognosis but must be recognized and treated immediately to reduce the risk of serious sequelae.