Cornea, Cataract & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
Cornea, Cataract & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India.
Surv Ophthalmol. 2018 Mar-Apr;63(2):214-235. doi: 10.1016/j.survophthal.2017.09.005. Epub 2017 Sep 19.
Ocular chemical burns are an ophthalmic emergency and are responsible for 11.5%-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, antifibrinolytic agents, antioxidants, collagen cross-linking, and inhibitors of corneal neovascularization.
眼化学烧伤是眼科急症,占眼部损伤的 11.5%-22.1%。在急性眼部烧伤中,广泛推荐立即进行大量冲洗,以去除有害物质并最大限度地减少损伤。常规医学治疗包括使用促进上皮化、减轻炎症和预防瘢痕并发症的药物。生物液如自体血清、脐带血血清、富含血小板的血浆和羊膜混悬液是生长因子的丰富来源,当用作常规治疗的辅助手段时,可促进愈合。急性眼部烧伤的手术治疗包括清除坏死组织、应用组织粘合剂、腱膜松解术和成形性角膜移植术。羊膜移植是一种新的手术治疗方法,越来越多地被用作常规治疗的辅助手段,以促进上皮愈合、减轻疼痛和恢复视力。目前正在评估各种旨在促进伤口愈合和减轻炎症的实验性治疗方法,如人间质和脂肪干细胞、β-1,3 葡聚糖、血管紧张素转换酶抑制剂、培养的成纤维细胞、去铁胺锌、纤维蛋白溶解抑制剂、抗氧化剂、胶原交联和角膜新生血管抑制因子。