INTRAOCULAR COMPLICATIONS FOLLOWING SEVER E EYE BURNS - FREQUENCY ANDMANAGEMENT

Background The prognosis of severe eye burns is determined by the area of the injured conjunctiva and the damage of the cornea. Furthermore the extension of damage to intraocular structures influences the clini cal course and the surgical management. Patients The clinical course o f 66 patients with 90 severely burnt eyes in the time from January 198 5 to December 1993 were examined with special regard to primary and se condary intraocular complications. Results In 62 (68.9%) eyes, the who le anterior eye segment was burnt, while in 28 (31.1%) eyes the damage was limited to the cornea and limbus. A cataract occurred in 23 (25.6 %) eyes short time after the burn and an early secondary glaucoma in 1 4 (15.6%) eyes. In the further clinical course, 41 (45.6%) eyes develo ped a secondary cataract and 20 (22.2%) eyes a late secondary glaucoma . Within 3 months after the burn, 18 eyes were treated with a Tenon pl asty, a penetrating keratoplasty and a cataract extraction. In 12 eyes a cataract extraction was combined with a penetrating keratoplasty mo re than one year after the injury. In the other cases cataract extract ion and keratoplasty were performed in seperate operations. In 8 eyes intraocular lenses were implanted. In 15 (16.6%) eyes secondary glauco ma had to be treated by trabeculectomy or by the implantation of a von Denffer implant. Penetrating keratoplasty was performed in 55 eyes, 3 5 of them were unsuccessfull as a consequence of graft rejection or in creasing vascularisation. One third of the patients achieved a long-te rm visual acuity of 0.1 and more. Conclusion After severe burn a high rate of intraocular complications has to be expected. The surgical man agement of such eyes differs from standard procedures. Principally, al l devitalized tissue of the anterior chamber like fibrinous and retroc orneal membranes should be excised in an early stage after the burn. P enetrating keratoplasties and extraction of the cataractous lens shoul d be performed in a combined procedure. The implantation of an intraoc ular lens is limited to a few special cases.