Posters

Spontaneous corneal re-epithelization of a total ocular surface burn case via 'Gata treatment protocol' in four weeks

Poster Details

First Author: S.Altun TURKEY

Co Author(s):    U. Erdem   A. Ilhan   U. Yolcu   S. Yildiz           

Abstract Details

Purpose:

To present the clinical outcomes of a severe lime injury with total ocular surface burns remains 22 days without any sign of corneal epithelial recovery.

Setting:

We have been treated severe acute corneal chemical burns with HBO Assisted treatment protocol (GATA protocol) without syblepharon formation. We don't use conformer or swap. If the treatment continued, cornea maintains avascular even after one month.

Methods:

The patient applied with excessive conjunctival hyperemia, corneal edema, total limbal ischemia and epithelial defect in his left eye. Anterior segment structures were hardly visible. Visual acuity was 20/400. Initially after hospitalization of the patient, our protocol including outologous platelet-rich-plasma(PRP), topical antibiotic oinments, systemic steroids, doxycycline, vitamin C and hyperbaric oxygen therapy started. We did not use conformer, swap or contact lens.

Results:

The cornea remained deepithelized for 22 days. Than, it started to re-epithelize from an 1 mm limbal island and re-epithelization was completed in two weeks. In his final visit after 18 months; visual acuity was 20/25. There was only a small peripheral vascularization in the nasal sector. Other ocular surface structure were normal

Conclusions:

Severe alacaline burns of the ocular surface (Dua, Stage 6) usually results in excessive corneal neovascularization, symblepharon and/or ankyloblepharon. Interestingly, none of these complications were faced. Amniotic membrane transplantation and limbal stem-cell transplantation are commonly suggested alternatives in such cases even in the early phases. We assume that remnants of limbal stem cells in deep crypts are responsible for the re-epithelization. These cells, even in very small numbers, may provide the whole cornea with healtyh epithelium if supported by growth factors and hyperbaric oxygen. We suggest ophthalmologists not to be impetuous about surgery and give these cells a chance.

Financial Disclosure:

NONE