RETROSPECTIVE STUDY OF SEVERE ALKALI BURNS OF THE EYE

Background Alkali bums are of special interest because of the rapid and deep penetration of alkali into the ocular tissues. Patients and methods This report examines the epidemiology, management and outcome of 42 cases of alkali burns of the eye admitted to the eye clinic of the RWTH Aachen from 1985 to 1992. Aspects examined were the nature of accident, type of alkali, treatment and complications. The intention was to use this information for improvement of prevention and treatment of these cases. Results The age analysis showed the greatest at-risk population were the 20-40 year-old patients. 73.8% were industrial accidents, 30% happened to builders and labourers, 20% in the chemical industry and 20% in machine factories. At home most of the injuries were caused by lime and drain cleaners. Sodium and potassium hydroxide produced more extended and deeper damages than lime due to their rapid penetration through the ocular tissues. A delayed surgical intervention led to a longer time of stay in hospital and to a higher number of operations. All eyes could be prevented from melting, but an optical rehabilitation (visual acuity >0.3) was achieved only in a few cases (14.5%). Conclusion There is a need to ensure adequate public awareness of the danger of alkali bums to the eye. Beside the primary prevention, adaequate first aid with immediate and continuous irrigation is of paramount importance. A uniform concept for the management of these severe cases is nessesary including an antiinflammatory medical and surgical treatment.