Alkali ocular burns in Martinique (French West Indies) Evaluation of the use of an amphoteric solution as the rinsing product.
CONCLUSIONS
During the 4 years of this study, we noted 66 cases of alkali ocular burns, or approximately 16 cases per year, nearly half (45.5%) of which are due to an assault. For grade 1 and 2 burns the time elapsed to reepithelialization appears to be shorter when rinsed with Diphoterine* versus physiological solution.


OBJECTIVE
Comparison of the effectiveness of two rinsing solutions for emergency use: a physiological solution and an amphoteric solution (Diphoterine*, Laboratories Prevor, Valmondois, France). Description of the clinical and progressive characteristics of alkali burns treated at the University Hospital Center of Fort de France in Martinique (French West Indies).


METHODS
Prospective consecutive observational case series and nonrandomized comparative study.


METHODS
Sixty-six patients were included. The total number of burned eyes is 104. Forty-eight eyes (46%) were rinsed with physiological solution and 56 eyes (54%) with Diphoterine*.


METHODS
All patients benefited from an ocular rinse with 500ml of physiological solution or Diphoterine*, followed by a complete ophthalmologic exam. The ocular injuries were classified according to the Roper-Hall modification of the Hughes classification system. The same standardized therapeutic protocol was applied and adapted to the seriousness of the burn.


METHODS
Demographic data, time to corneal reepithelialization, final best corrected visual acuity and complications were analysed.


RESULTS
Twenty-eight (42.4%) patients have a unilateral burn and 38 (57.6%) patients have bilateral burns. In decreasing order of frequency, the circumstances surrounding the injury are: assaults in 45.5% of cases (n=30), work-related accidents in 32% of cases (n=31), and domestic accidents in 23% of cases (n=15). For grade 1 and 2 burns the time elapsed to reepithelialization appears to be shorter when rinsed with Diphoterine* versus physiological solution (respectively): 1.9+/-1 days versus 11.1+/-1.4 days (p=10(-7)) and 5.6+/-4.9 days versus 10+/-9.2 days (p=0.02). For grade 3 and 4 burns, there are complications in 11 cases (11.6%): 8 corneal opacities and 3 perforations.


CONCLUSIONS
This study is the first conducted in humans that takes into account the type of ocular rinse product used in the progressive follow-up study of injuries. The time elapsed to reepithelialization is shorter with Diphoterine* for grade 1 and 2 burns. There are not enough cases of grade 3 and 4 burns to make a conclusion. Diphoterine* seems very effective in terms of its mechanism of action and the experimental and clinical results.
Merle
Harold
H
Service d'Ophtalmologie, Centre Hospitalier Universitaire de Fort de France, Hôpital Pierre Zobda Quitman, BP 632, 97261 Fort de France Cedex, Martinique -- France (French West Indies). harold.merle@chu-fortdefrance.fr
Donnio
Angélique
A
Ayeboua
Lucas
L
Michel
Franck
F
Thomas
Félix
F
Ketterle
Jeannine
J
Leonard
Christian
C
Josset
Patrice
P
Gerard
Max
M
D000061:Accidents, Home; D000062:Accidents, Occupational; D000328:Adult; D000468:Alkalies; D002057:Burns, Chemical / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D005126:Eye Burns / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000139:chemically induced / Q000150:complications / Q000188:drug therapy; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D009930:Organic Chemicals; D011446:Prospective Studies; D016896:Treatment Outcome; D014754:Violence; D014945:Wound Healing / Q000502:physiology
D000468:Alkalies; D009883:Ophthalmic Solutions; D009930:Organic Chemicals; C472007:diphoterine