Accepted Manuscript Treatment of Acute Ocular Chemical Burns Namrata Sharma, MD, Manpreet Kaur, MD, Tushar Agarwal, MD, Virender S. Sangwan, MS, Rasik B. Vajpayee, FRCS(Edin), FRANZCO PII: S0039-6257(16)30201-6 DOI: 10.1016/j.survophthal.2017.09.005 Reference: SOP 6754 To appear in: Survey of Ophthalmology Received Date: 11 October 2016 Revised Date: 8 September 2017 Accepted Date: 11 September 2017 Please cite this article as: Sharma N, Kaur M, Agarwal T, Sangwan VS, Vajpayee RB, Treatment of Acute Ocular Chemical Burns, Survey of Ophthalmology (2017), doi: 10.1016/j.survophthal.2017.09.005. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
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Treatment of acute ocular chemical burns.download.xuebalib.com/2xy8JNd8QwK6.pdf · Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5% to 22.1% of ocular
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Please cite this article as: Sharma N, Kaur M, Agarwal T, Sangwan VS, Vajpayee RB, Treatment ofAcute Ocular Chemical Burns, Survey of Ophthalmology (2017), doi: 10.1016/j.survophthal.2017.09.005.
This is a PDF file of an unedited manuscript that has been accepted for publication. As a service toour customers we are providing this early version of the manuscript. The manuscript will undergocopyediting, typesetting, and review of the resulting proof before it is published in its final form. Pleasenote that during the production process errors may be discovered which could affect the content, and alllegal disclaimers that apply to the journal pertain.
membrane suspension) were reviewed. Regarding amniotic membrane transplantation in
acute ocular burns, all articles were reviewed since the first use of amniotic membrane in
ocular burns in 1986. For statements that are frequently mentioned in the literature, we chose
the earliest publication and other important articles.
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Abbreviations
Epidermal growth factor (EGF)
Hyaluronic acid (HA)
Synthetic inhibitors of metalloproteinases (SIMP)
Polymorphonuclear leukocytes (PMNL)
Non-steroidal anti-inflammatory drugs (NSAIDs)
Human Immunodeficiency Virus (HIV)
Amniotic membrane transplantation (AMT)
Phosphate buffered saline (PBS)
Dimethylsulfoxide (DMSO)
Deep anterior lamellar keratoplasty (DALK)
Conjunctival limbal autograft (CLAU)
Scleral contact lens (SCL)
Mesenchymal stem cells (MSCs)
Human corneal epithelial cells (HCECs)
Dulbecco's modified Eagle's medium (DMEM)
Epsilon-aminocaproic acid (EACA)
Tranexamic acid (TXA)
Angiotensin-converting enzyme (ACE)
Collagen cross linking (CXL)
Vascular endothelial growth factor (VEGF)
Chondrocyte-derived extracellular matrix (CDECM)
Doxycycline temperature-sensitive hydrogel (DTSH)
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Figure legends:
Figure 1: Grade V (Dua’s classification) acute ocular chemical burn receiving topical umbilical
cord serum in addition to conventional treatment (a) at presentation (b) one month after receiving
topical umbilical cord serum
Figure 2: Grade IV (Dua’s classification) acute ocular chemical burn undergoing AMT (a)
preoperative (b) one month postoperative
Figure 3: Management of acute ocular chemical burns
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Table 1: Roper-Hall classification for the severity of ocular surface burns188
Grade Clinical Findings Prognosis
Cornea Conjunctiva/Limbus
I Corneal epithelial damage No limbal ischemia Good
II Corneal haze, iris details
visible
<1/3 limbal ischemia Good
III Total epithelial loss, stromal
haze and iris details obscured
1/3-1/2 limbal ischemia Guarded
IV Cornea opaque, iris and pupil
obscured
>1/2 limbal ischemia Poor
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Table 2: Dua classification for severity of ocular surface burns51
Grade Clinical Findings Conjunctival Involvement
Analogue Scale (Clock hours of limbal involvement/ % bulbar
conjunctival involvement)
Prognosis
I 0 clock hours limbal involvement
0% 0/0% Very good
II ≤3 clock hours limbal involvement
≤30% 0.1-3/ 1-29.9% Good
III >3-6 clock hours limbal involvement
>30-50% 3.1-6/ 31-50% Good
IV >6-9 clock hours limbal involvement
>50-75% 6.1-9/ 51-75% Good to guarded
V >9-<12 clock hours limbal involvement
>75-<100% 9.1-11.9/ 75.1-99.9% Guarded to poor
VI Total (12 clock hours) limbal involvement
100% (Total) 12/ 100% Very poor
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Table 3: Biological Properties and Dose of Topical Biological Fluids used in Treatment of Acute Ocular Chemical Burns