Surgical management of chemical and thermal burns of the eye in Tabriz Nikukari Educational and Medical Center

Abstract

Chemical injuries to the conjunctiva and cornea, including damage by alkaline and acidic substances, are ophthalmic emergencies and require immediate intervention. Chemical damage to the eye can lead to severe and extensive damage to the globe's surface and the anterior segment, which can cause visual and motor disorders of the eye. This study aimed at the surgical management of chemical and thermal eye burns in Tabriz Charity Training and Treatment Center. Materials and Methods: Patients referred to the Nikukari hospital with chemical and thermal corneal burns from 2016 to 2019 were selected for surgery by one of four methods (AMT, KLAL, CLAU, and PKP) selected. In the regular and serial examinations performed pre-surgery, three months and one year after surgery, and the last post-surgery visit, the findings of complete clinical eye examination of patients were reviewed. Results: In this study, 40 patients with chemical and thermal burns of the eye with a mean age of 31.5 years were studied. The minimum age of patients was four years, and the maximum was 78 years. 80% of patients were male. In 3 patients, thermal burns with boiling water, 22 patients with acid burns, and 15 patients with alkaline burns were causes of injury. In all patients, the initial surgery was AMT. However, 52.5% of patients underwent surgery only once. Other patients underwent KLAL (4 cases), CLAU (9 cases), and PKP (6 cases). Also, five patients underwent tenoplasty, two patients underwent mucosal infection, and nine underwent Symblepharon release + Fornix reconstruction. Ten patients were at LP in terms of visual acuity, which had decreased to 5 patients after 12 months of follow-up. Also, in general, 50% of patients significantly improve their vision. Regarding the clinical examination of patients, it was observed that IOP had improved to normal after 12 months of surgery in 82.5% of patients. Also, 17.5% of patients had corneal angiogenesis, and 12.5% of them had stable corneal epithelial damage.