| Purpose Even undergo positive treatments in clinic, acute severe injuries of the eye may produce extensive damages to the ocular surface epithelium and anterior segment, resulting in poor prognosis.Our study is to retrospectively analyse acute severe eye burns of 26 years and illuminate outcomes of corneal repairment, blindness and complications, so as to evaluate the prognosis and help to improve curative effect.Methods From 1977 to 2002, there were totally 135 cases 155 eyes with acute severe ocular chemical and thermal burns admitted to Southwest Hospital of Third Military Medical University, Chongqing. Divided them into acid, alkali, and thermal groups, firstly filled clinical details into designed questionnaires respectively. Secondly, made 2 Excel sheets according to outcomes of corneal repairment, blindness and complications, then transmitted information in those questionnaires into the sheets. Finally transformed Excel tables into SPSS ones and made statistical process.Results (1) Clinical characteristics of acute severe eye burns: 86.7%were male patients, 13.3% were females, and the greatest at-risk population were the 20-40 year old patients, accounting for 80.6%. Between acid, alkali, and thermal groups, thermal burns were the most usual causes, accounting for 50.0%, acid burns were the rarest causes, accounting for 15.0%. Grade III and IV injuries had gradually increased before 1999. However from 1999, the number of patients admitted have mounted up much more than the past years and the severity of burns tended to be aggravated. The principal cause of injuries for adults was work wounds (81.8%), and for minors it was contretemps(83.3%). Alkali was the principal type of burns among minors(61.1%). In female patients, acid and thermal burns accounted for 35.7% respectively, caused by purposive hurt as well as work wound. Oil of vitriol was the most primary injurants of acid burns(75%).Lime was the most primary injurants of alkali burns(48%). Melting aluminium was the most primary injurants of thermal burns(53%).(2) Harmness of common types of injurants in acute severe eye burns: In our study, acute severe eye burns caused by acid, alkali, or thermal were almost the same in distributing frequency of Grade III and Grade IV burns.(3) Corneal repair:In Grade III eye burns, there were significant differences of coreal repair time between acid, alkali, and thermal(P=0.043). In acid burns, the eyes whose corneal repair time≤3 weeks accounted for 23.0%, 4-7 weeks for 38.5%, 8-15 weeks for 38.5%. In alkali burns, ≤3 weeks accounted for 22.6%, 4-7 weeks for 74.2%, 8-15 weeks for 3.2%.That was to say, the corneal repair time of acid burns was significantly longer than alkali(P=0.006). Between not only alkali and thermal burns, but also acid and thermal burns there were no significant differences of corneal repair time.In Grade IV eye burns, there were significant differences of coreal repair incidence between acid(22.2%), alkali(72.7%), and thermal(42.9%)(P=0.018). The coreal repair incidence of alkali burns was significantly more than acid(P=0.017) and thermal burns(P=0.028).The corneal repair incidence showed no significant differences between acid and thermal burns. The reason why the coreal repair incidence of alkali burns was significantly more than acid and thermal burns was analysed as the following: among the 9 eyes of acid burns, the 22 eyes of alkali burns and the 35 eyes of thermal eyes, incidence of lid ectropion(44.4%) and corneal perforation(66.7%) in acid burns were both significantly more than those of alkali burns(lid ectropion: 4.5%, P=0.017; perforation 9.1%, P=0.003). Between alkali and thermal burns, no significant differences were showed in complications.In Grade IV eye burns, there were no significant differences of coreal repair time between acid, alkali, and thermal burns. There indicated significant differences of causes of coreal unrepair between the 3 groups of burns(P=0.040).In the Grade IV injuried eyes with unrepaired corneas, the incidence of corneal perforation(85. |
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