title: Long-term management of severe ocular surface injury due to methamphetamine production accidents.
abstract: OBJECTIVE
  The aim of this study was to report the clinical features and management of patients with ocular surface damage during methamphetamine production accidents.
  
  
  METHODS
  This is a retrospective noncomparative interventional case series of 5 patients with methamphetamine production-related ocular injuries referred to the Cincinnati Eye Institute between 1999 and 2014.
  
  
  RESULTS
  Four of 5 cases were white young men with severe bilateral ocular injury and extremely poor vision. All except 1 eye (9 of 10) were diagnosed with total or near-total ocular surface failure. Limbal stem cell transplantation was performed in 8 of 10 eyes. Keratolimbal allograft was followed by penetrating keratoplasty in 7 of 10 eyes. Ocular surface stability was achieved in 7 of 10 eyes after keratolimabl allograft. Postoperative visual acuity was better than 20/200 in 4 of 10 of eyes. Keratolimbal graft rejection occurred in 3 of 10 eyes; the rate of rejection of penetrating keratoplasty was also 3 out of 10 eyes.
  
  
  CONCLUSIONS
  Methamphetamine-related accidents can lead to severe bilateral ocular injuries. Although stem cell transplantation procedure success is guarded in most of these patients because of severe conjunctival inflammation and accompanying ocular comorbidities, as well as personality issues, compliant patients can achieve good visual function with ocular surface transplantation and subsequent keratoplasty.
authors: *Cincinnati Eye Institute, Edgewood, KY; †Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; and ‡Department of Ophthalmology, University of Cincinnati, Cincinnati, OH.
authors: Asadolah
authors: A
authors: Movahedan
authors: Brad M
authors: BM
authors: Genereux
authors: Mahshad
authors: M
authors: Darvish-Zargar
authors: Kevin J
authors: KJ
authors: Shah
authors: Edward J
authors: EJ
authors: Holland
mesh_terms: D000328:Adult; D064591:Allografts; D002057:Burns, Chemical / Q000209:etiology / Q000601:surgery*; D000697:Central Nervous System Stimulants / Q000138:chemical synthesis*; D003316:Corneal Diseases / Q000209:etiology / Q000601:surgery*; D004339:Drug Compounding / Q000009:adverse effects*; D005126:Eye Burns / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015948:Keratoplasty, Penetrating; D016850:Limbus Corneae / Q000166:cytology; D008297:Male; D008694:Methamphetamine / Q000138:chemical synthesis*; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014792:Visual Acuity / Q000502:physiology
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine