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Corneal Endothelial Decompensation after Ocular Chemical Burn: Description of a New Finding


Steinemann, Alexandra; Blaser, Frank; Livny, Eitan; Baenninger, Philipp; Marti, Marvin; Gerber-Hollbach, Nadine; Eggenschwiler, Laura; Gatzioufas, Zisis; Goldblum, David (2019). Corneal Endothelial Decompensation after Ocular Chemical Burn: Description of a New Finding. Klinische Monatsblätter für Augenheilkunde, 236(4):371-376.

Abstract

BACKGROUND
Ocular chemical burn is an ophthalmological emergency. Therefore, chemical injuries should be promptly addressed in order to initiate the appropriate treatment as soon as possible and optimize the visual prognosis. We present a retrospective study of ten cases with ocular chemical burn including one with superglue and one with a liquid plaster material injury and describe their clinical course.

HISTORY AND SIGNS
Ten adult patients (34 - 92 years, 8 males) presented with moderate to severe alkali or neutral chemical burns in our emergency clinics. They exhibited a variable degree of conjunctival injection, limbal ischemia, corneal erosion, and Descemet's folds.

THERAPY AND OUTCOME
Patients were treated and complete corneal epithelial closure was achieved in all cases without significant signs of limbal stem cell insufficiency. Corneal endothelial insufficiency was observed in all cases. Nine patients had to be listed for corneal endothelial keratoplasty and one was treated with Descemet's stripping endothelial automated keratoplasty.

CONCLUSIONS
Isolated corneal endothelial decompensation after chemical burns has not yet been described. The pathophysiological explanation of this observation remains, however, unknown. In view of this rare complication, it is important to follow patients after chemical ocular burn for possible development of endothelial decompensation.

Abstract

BACKGROUND
Ocular chemical burn is an ophthalmological emergency. Therefore, chemical injuries should be promptly addressed in order to initiate the appropriate treatment as soon as possible and optimize the visual prognosis. We present a retrospective study of ten cases with ocular chemical burn including one with superglue and one with a liquid plaster material injury and describe their clinical course.

HISTORY AND SIGNS
Ten adult patients (34 - 92 years, 8 males) presented with moderate to severe alkali or neutral chemical burns in our emergency clinics. They exhibited a variable degree of conjunctival injection, limbal ischemia, corneal erosion, and Descemet's folds.

THERAPY AND OUTCOME
Patients were treated and complete corneal epithelial closure was achieved in all cases without significant signs of limbal stem cell insufficiency. Corneal endothelial insufficiency was observed in all cases. Nine patients had to be listed for corneal endothelial keratoplasty and one was treated with Descemet's stripping endothelial automated keratoplasty.

CONCLUSIONS
Isolated corneal endothelial decompensation after chemical burns has not yet been described. The pathophysiological explanation of this observation remains, however, unknown. In view of this rare complication, it is important to follow patients after chemical ocular burn for possible development of endothelial decompensation.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Ophthalmology Clinic
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Ophthalmology
Language:English
Date:April 2019
Deposited On:13 Feb 2020 10:26
Last Modified:29 Jul 2020 14:16
Publisher:Georg Thieme Verlag
ISSN:0023-2165
OA Status:Closed
Publisher DOI:https://doi.org/10.1055/a-0857-6538
PubMed ID:30999333

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