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WGA Rescources

Abstract #75295 Published in IGR 19-2

Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities

Dohlman CH; Cade F; Regatieri CV; Zhou C; Lei F; Crnej A; Harissi-Dagher M; Robert MC; Papaliodis GN; Chen D; Aquavella JV; Akpek EK; Aldave AJ; Sippel KC; DʼAmico DJ; Dohlman JG; Fagerholm P; Wang L; Shen LQ; González-Andrades M; Chodosh J; K
Cornea 2018; 37: 248-251


PURPOSE: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases. METHODS: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed. RESULTS: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital. CONCLUSION: A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state.

Cornea Service and Boston Keratoprosthesis Laboratory, Massachusetts Eye and Ear Infirmary and Schepens Eye Research Institute, Harvard Medical School, Boston, MA.

Full article

Classification:

9.4.7 Glaucomas associated with ocular trauma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)



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