Surv Ophthalmol. 2017 Sep 18. pii: S0039-6257(16)30201-6. doi: 10.1016/j.survophthal.2017.09.005. [Epub ahead of print]

Treatment of Acute Ocular Chemical Burns.

Sharma N¹, Kaur M², Agarwal T², Sangwan VS³, Vajpayee RB⁴.

Abstract

Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5% to 22.1% of ocular injuries. Immediate copious irrigation is universally recommended in acute ocular burns to remove the offending agent and minimize damage. Conventional medical therapy consists of the use of agents that promote epithelialization, minimize inflammation, and prevent cicatricial complications. Biological fluids such as autologous serum, umbilical cord blood serum, platelet-rich plasma, and amniotic membrane suspension are a rich source of growth factors and promote healing when used as adjuncts to conventional therapy. Surgical treatment of acute ocular burns includes the debridement of the necrotic tissue, application of tissue adhesives, tenoplasty, and tectonic keratoplasty. Amniotic membrane transplantation is a novel surgical treatment that is increasingly being used as an adjunct to conventional treatment to promote epithelial healing, minimize pain, and restore visual acuity. Various experimental treatments that aim to promote wound healing and minimize inflammation are being evaluated such as human mesenchymal and adipose stem cells, beta-1,3 glucan, angiotensin-converting enzyme inhibitors, cultivated fibroblasts, zinc desferrioxamine, anti-fibrinolytic agents, antioxidants, collagen cross-linking, and inhibitors of corneal neovascularization.