Ram Jagat, Sukhija Jaspreet, Behera Digamber, Gupta Amod
Department of Ophthalmology, Post-Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
Ophthalmic Surg Lasers Imaging. 2010 Jan-Feb;41(1):123-7. doi: 10.3928/15428877-20091230-22.
A report on formic acid-induced ocular and systemic injuries.
Forty-two passengers (84 eyes) with formic acid burns following a tanker and bus collision were evaluated and treated. The severity of ocular chemical injury was assessed using the Roper-Hall classification. Standard protocol for management of ocular chemical burns was adopted in all patients. Immediate irrigation of the eyes was done with tap water and all patients received frequent topical steroids, cycloplegics, and lubricating eye drops. Systemic injuries were evaluated and managed collectively by plastic and orthopedic surgeons and internists.
On presentation, 48 (57.14%) eyes had grade 0, 13 (15.48%) eyes had grade I, 16 (19.1%) eyes had grade II, 3 (3.57%) eyes had grade III, and 4 (4.76%) eyes had grade IV chemical injuries. Thirty patients (71.43%) had superficial and 12 (28.57%) had deep skin burns. One (2.38%) patient died due to severe pulmonary edema and 6 (14.29%) patients had severe pulmonary complications requiring oxygen treatment. Seventy-two (87.8%) eyes healed without residual sequelae, 10 (12.2%) eyes had nebulo-macular corneal opacities, and 2 (2.44 %) eyes developed secondary glaucoma and dry eye.
Formic acid injuries can lead to a significant ocular and systemic morbidity. Immediate ocular and systemic management is necessary to reduce morbidity and mortality. Strict regulations are needed for the transportation of dangerous chemicals to prevent accidental chemical injuries.
关于甲酸致眼及全身损伤的报告。
对42名在油轮与巴士相撞事故中眼部被甲酸烧伤的乘客（84只眼）进行评估与治疗。采用Roper-Hall分类法评估眼化学伤的严重程度。所有患者均采用眼化学烧伤的标准处理方案。立即用自来水冲洗眼睛，所有患者均频繁接受局部类固醇、睫状肌麻痹剂及润滑眼药水治疗。全身损伤由整形外科医生、骨科医生及内科医生共同评估与处理。
就诊时，48只眼（57.14%）为0级，13只眼（15.48%）为Ⅰ级，16只眼（19.1%）为Ⅱ级，3只眼（3.57%）为Ⅲ级，4只眼（4.76%）为Ⅳ级化学伤。30例患者（71.43%）为浅表皮肤烧伤，12例患者（28.57%）为深部皮肤烧伤。1例患者（2.38%）因严重肺水肿死亡，6例患者（14.29%）有严重肺部并发症需吸氧治疗。72只眼（87.8%）愈合且无残留后遗症，10只眼（12.2%）有角膜云翳-斑翳，2只眼（2.44%）发生继发性青光眼及干眼。
甲酸损伤可导致严重的眼及全身发病。立即进行眼及全身处理对于降低发病率和死亡率很有必要。需要对危险化学品运输制定严格规定以防止意外化学伤。
