Schrage Norbert Franz, Kompa Sirpa, Haller Wolfram, Langefeld Stéphanie
Department of Ophthalmology, Eye-Clinic RWTH Aachen, Pauwelstrasse 30, D-52057 Aachen, Germany.
Burns. 2002 Dec;28(8):782-6. doi: 10.1016/s0305-4179(02)00194-8.
Severe eye burns occur rarely, but are related to a poor prognosis in rehabilitation. As emergency treatment has been identified as decisive factor for the prognosis of eye burns, new first aid rinsing solutions should be considered carefully in their clinical action. In a first approach, the new drug Diphoterine was subjected to a comparison with saline solution to evaluate the effects in a model of severe eye burns.
In a double-masked experiment 16 rabbits underwent a severe eye burn of one cornea followed by immediate rinsing with 0.9% sodium-chlorine solution (n=8) or Diphoterine (n=8). During 16 days after burn, an irrigation therapy with 0.9% saline solution three times daily 160 ml was applied in both groups following the recommendation of prolonged irrigation therapy performed in our clinic. In a similar setup, 16 eyes were subjected alkali burns with measurements of aqueous humor pH within 30s after burn and after a period of 5 min rinsing with 500 ml saline 0.9% or Diphoterine, respectively.
The result of the severe eye burn with an opaque cornea was similar in both groups. During rinsing no fibrin precipitates occurred in the Diphoterine rinsed group whereas this was detectable in all eyes rinsed with saline solution. After 16 days there was no difference between both groups indicating no harmful effect of Diphoterine as emergency treatment compared to saline 0.9%. After 30s of burn with 1N NaOH and rinsing with 500 ml of the specified solutions the anterior chamber pH was 10+/-0 in the saline group and 9.35+/-0.3 in the Diphoterine group showing efficacy of the buffering capacity of Diphoterine.
Diphoterine proves to be efficient in the primary treatment of burns. The anterior chamber pH could be lowered by 5min of rinsing. No harmful effects of Diphoterine could be observed compared to rinsing with saline solution in the course of an severe alkali burn of the cornea.
严重眼烧伤虽罕见，但与康复预后不良相关。由于紧急治疗已被确认为眼烧伤预后的决定性因素，因此应仔细考虑新型急救冲洗液的临床作用。在初步研究中，将新型药物多聚磺酸粘多糖与生理盐水进行比较，以评估其在严重眼烧伤模型中的效果。
在一项双盲实验中，16只兔子的一只角膜遭受严重眼烧伤，随后立即用0.9%氯化钠溶液（n = 8）或多聚磺酸粘多糖（n = 8）冲洗。在烧伤后的16天内，根据我们诊所进行的长时间冲洗治疗建议，两组均每日3次应用160毫升0.9%生理盐水进行冲洗治疗。在类似的设置中，16只眼睛遭受碱烧伤，分别在烧伤后30秒以及用500毫升0.9%生理盐水或多聚磺酸粘多糖冲洗5分钟后测量房水pH值。
两组角膜混浊的严重眼烧伤结果相似。冲洗过程中，多聚磺酸粘多糖冲洗组未出现纤维蛋白沉淀，而在所有用生理盐水冲洗的眼睛中均可检测到。16天后，两组之间无差异，表明与0.9%生理盐水相比，多聚磺酸粘多糖作为紧急治疗无有害影响。在用1N氢氧化钠烧伤30秒并用500毫升指定溶液冲洗后，生理盐水组前房pH值为10±0，多聚磺酸粘多糖组为9.35±0.3，显示出多聚磺酸粘多糖的缓冲能力有效。
多聚磺酸粘多糖在烧伤的初步治疗中被证明是有效的。冲洗5分钟可降低前房pH值。在角膜严重碱烧伤过程中，与用生理盐水冲洗相比，未观察到多聚磺酸粘多糖有有害影响。
