RETROSPECTIVE STUDY OF SEVERE ALKALI BURN S OF THE EYE

Background Alkali bums are of special interest because of the rapid an d deep penetration of alkali into the ocular tissues. Patients and met hods 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 acc ident, 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 pop ulation were the 20-40 year-old patients. 73.8% were industrial accide nts, 30% happened to builders and labourers, 20% in the chemical indus try and 20% in machine factories. At home most of the injuries were ca used by lime and drain cleaners. Sodium and potassium hydroxide produc ed more extended and deeper damages than lime due to their rapid penet ration through the ocular tissues. A delayed surgical intervention led to a longer time of stay in hospital and to a higher number of operat ions. All eyes could be prevented from melting, but an optical rehabil itation (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, adae quate first aid with immediate and continuous irrigation is of paramou nt importance. A uniform concept for the management of these severe ca ses is nessesary including an antiinflammatory medical and surgical tr eatment.