Use of an amphoteric lavage solution for emergency treatment of eye burns. First animal type experimental clinical considerations.
OBJECTIVE
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Schrage
Norbert Franz
NF
Department of Ophthalmology, Eye-Clinic RWTH Aachen, Pauwelstrasse 30, D-52057 Aachen, Germany. schrage@acto.de
Kompa
Sirpa
S
Haller
Wolfram
W
Langefeld
Stéphanie
S
D000468:Alkalies; D000666:Amphotericin B / Q000627:therapeutic use*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002057:Burns, Chemical / Q000188:drug therapy* / Q000473:pathology; D003315:Cornea / Q000473:pathology; D065306:Corneal Injuries; D003318:Corneal Opacity / Q000209:etiology / Q000473:pathology; D003320:Corneal Ulcer / Q000209:etiology / Q000473:pathology; D004638:Emergency Treatment; D005126:Eye Burns / Q000188:drug therapy* / Q000473:pathology; D023421:Models, Animal; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D011817:Rabbits; D011897:Random Allocation; D016037:Single-Blind Method; D012965:Sodium Chloride / Q000627:therapeutic use; D007507:Therapeutic Irrigation; D013997:Time Factors
D000468:Alkalies; D000900:Anti-Bacterial Agents; D009883:Ophthalmic Solutions; D012965:Sodium Chloride; D000666:Amphotericin B