[Recommendations for acute treatment for chemical and thermal burns of eyes and lids].
With these recommendations the authors want to improve the acute therapy of eye burns based on the literature and clinical experience. Due to the lack of studies with high evidential value we base these recommendations on the results of experimental work and reports of successfully treated eye burns. A development of this document by systematic research is necessary. Despite the limited knowledge, the collated facts are the current state of the art of treatment according to the knowledge and research of the authors. The most important clinical recommendation is to rinse a chemically or thermally burnt eye as soon and as extensively as possible. Any delay worsens the prognosis. Substances on the market for first aid have different levels of clinical evidence. Thus saline and amphoteric diphoterine have been evaluated in a prospective clinical study showing an advantage for the amphoter. Water, borate buffer, phosphate buffers and derivatives have never been proven to work in clinical applications. Nevertheless, they are recommended. Within experimental work in vitro we could show the value of polyvalent decontamination. Side-effects of phosphate buffers have been demonstrated in retrospective clinical and prospective experimental studies so that even in cases of beneficial effects on pH we cannot recommend these substances which propagate corneal calcification. Special types of burns, such as hydrofluoric acid need special treatment but as clinical studies are lacking only experimental data can offer suitable recommendations.
Klinik für Augenheilkunde, Kliniken der Stadt Köln gGmbH, Ostmerheimer Str. 200, 51109 Köln. schrage@acto.de
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Gerard
D002057:Burns, Chemical / Q000188:drug therapy* / Q000209:etiology*; D003666:Decontamination / Q000379:methods*; D005126:Eye Burns / Q000139:chemically induced* / Q000188:drug therapy*; D005143:Eyelids / Q000293:injuries*; D006801:Humans; D007509:Irritants / Q000633:toxicity*; D009883:Ophthalmic Solutions / Q000627:therapeutic use*; D007507:Therapeutic Irrigation / Q000379:methods
D007509:Irritants; D009883:Ophthalmic Solutions