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Wang ZW, Yin XF, Wang CX, Wang HZ, Zhou SY. Anterior segment optical coherence tomography for superficial keratectomy. Photodiagnosis Photodyn Ther 2024; 48:104237. [PMID: 38871017 DOI: 10.1016/j.pdpdt.2024.104237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/25/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024]
Abstract
PURPOSE To report the use of anterior segment optical coherence tomography (AS-OCT) for superficial keratectomy (SK) in anterior corneal opacity. METHODS The characteristics of 43 eyes (39 patients) with various lesions responsible for anterior corneal opacity were included in this retrospective non-comparative study. AS-OCT was performed on all eyes before surgery. The thickness of corneal opacity and the underlying healthy stroma were measured. SK was performed on each individual. RESULTS Four types of anterior corneal opacity were evaluated, including corneal degeneration (26/43), Reis-Bücklers corneal dystrophy (8/43), alkali burn (1/43) and corneal tumors (8/43). Based on AS-OCT images, all eyes showed abnormal hyper-reflective signals in the superficial cornea to less than one-third of the normal corneal thickness in the deepest corneal opacity. All 43 eyes underwent an SK procedure. In addition, 1 eye with alkali burns and 7 eyes with corneal tumors were combined with amniotic membrane transplantation. All eyes restored transparency without significant complications. CONCLUSION AS-OCT is a valuable method for objective preoperative and noninvasive assessments of anterior corneal opacities and is useful for guiding SK.
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Affiliation(s)
- Zi-Wen Wang
- Department of Ophthalmology, Jiangxi Yingtan People's Hospital, Jiangxi Province, China
| | - Xiao-Fang Yin
- Department of Ophthalmology, The Second People's Hospital of Guangdong Foshan, China
| | - Chun-Xiao Wang
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, SunYat-sen University, Guangzhou, China
| | - Hui-Zhen Wang
- Department of Ophthalmology, Jiangxi Yingtan People's Hospital, Jiangxi Province, China; The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, SunYat-sen University, Guangzhou, China
| | - Shi-You Zhou
- The State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, SunYat-sen University, Guangzhou, China.
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Taha M, Alzubaidi AA, AlHajri R, Albusaad R, Aljumaiah R, Aldwsri AS. Community-Level Awareness of Proper Immediate Steps for Ocular Chemical Injury in Saudi Arabia. Cureus 2023; 15:e45120. [PMID: 37842506 PMCID: PMC10569668 DOI: 10.7759/cureus.45120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND The human eyes are the most vital sensory organ. Eye injury is the main factor leading to monocular blindness. There is a lack of understanding in the Saudi community regarding the appropriate response to a chemical injury to the eyes. To provide accurate and clear medical information about ocular chemical damage, it is crucial to identify areas where healthcare professionals fall short. To address the gaps in critical knowledge, this study aimed to focus on the Saudi Arabian community to determine if healthcare professionals have fulfilled their responsibility as health promoters in providing education on eye emergencies. We examined the immediate reaction of the study participants to evaluate the community's awareness of chemical eye injuries and immediate management strategies. OBJECTIVES This study aimed to assess and evaluate the general population's knowledge and awareness of immediate management steps following an ocular chemical injury in Saudi Arabia. METHODOLOGY A cross-sectional design was employed. A random sampling method was used to select 2,295 individuals from the Saudi community. Participants completed an electronic closed-ended, pre-validated, anonymous, and self-administered questionnaire. RESULTS The majority of the respondents were females (71.6%) and Saudis (94.5%) aged 18 to 30 years (46.6%). The majority of the respondents correctly stated that eye injuries could cause complications (89.6%) and that common substances that could result in eye injuries are chloride and detergents (93.3%) and battery materials (73.1%). Furthermore, complications after eye injuries could include blindness (80.6%), perforation (44.5%), and scar formation (38.1%). A substantial proportion of the respondents indicated that water should be used to treat chemical injuries due to acidic and alkaline substances (68.1%). However, only a small proportion of the respondents correctly answered that the eyes should be washed for 30 minutes or more after an ocular injury (7.9%). CONCLUSIONS The overall knowledge levels on injury mechanisms and complications were generally high with a lack of knowledge regarding immediate management for injuries. Therefore, there is a need for targeted educational interventions and training programs to enhance the general public's understanding of immediate management strategies for chemical eye injuries.
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Affiliation(s)
- Medhat Taha
- Department of Anatomy, Umm Al-Qura University, Makkah, SAU
| | | | - Raneem AlHajri
- Department of Medicine, Arabian Gulf University, Manama, BHR
| | - Renad Albusaad
- Department of Neurology, King Faisal University, Al Hofuf, SAU
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Korkmaz I, Palamar M, Egrilmez S, Gurdal M, Yagci A, Barut Selver O. Evaluation of Limbal Stem Cell Transplant Success in Ocular Chemical Injury. EXP CLIN TRANSPLANT 2023; 21:684-690. [PMID: 34981716 DOI: 10.6002/ect.2021.0393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES We evaluated limbal stem cell transplant success in limbal stem cell deficiency due to chemical injury at a tertiary eye care center in Turkey with a novel system for describing limbal stem cell deficiency, as developed by the Limbal Stem Cell Working Group. MATERIALS AND METHODS Medical records of 80 eyes of 80 patients after limbal stem cell transplant for limbal stem cell deficiency secondary to chemical injury were included, with patients grouped according to surgical procedure, ie, limbal autograft, limbal allograft, and cultivated limbal epithelial cell transplant. Surgical success was defined as improvement in postoperative year 1 of limbal stem cell deficiency stage. RESULTS Patients' mean age was 37.9 ± 15.7 years (range, 4-71 years). Male/female ratio was 2.4. Forty-five patients (56.3%) were injured with alkaline substance, and 16 (20%) with acid substance. Mean follow-up time was 60.3 ± 30.6 months (range, 6-118.6 months). Limbal autograft, allograft, and cultivated limbal epithelial cell transplants were performed in 58 (72.5%), 12 (15%), and 10 (12.5%) eyes, respectively. Intervals between injury and surgery in limbal autograft, limbal allograft, and cultivated limbal epithelial cell transplants were 43.3 ± 94.1 months (range, 0.5-592 months), 14.5 ± 10.6 months (range, 2.4-32.5 months), and 122.8 ± 158.9 months (range, 21.1-504 months),respectively (P = .02); and surgical success rates in each group were 65.5%, 41.7%, and 90%, respectively (P = .03). Overall surgical success rate was 65%. CONCLUSIONS Accurate determination of the limbal stem cell deficiency stage is crucial for proper evaluation of surgical success. Surgery type and interval between injury and surgery were the most important factors associated with higher surgical success rates. Despite the limited number of patients in the subgroups, the results were remarkable to emphasize the significance of a novel limbal stem cell deficiency scoring system.
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Affiliation(s)
- Ilayda Korkmaz
- From the Department of Ophthalmology, Ege University, Izmir, Turkey
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Kate A, Sharma S, Yathish S, Das AV, Malepati N, Donthineni PR, Basu S, D’Souza S, Shanbhag SS. Demographic profile and clinical characteristics of patients presenting with acute ocular burns. Indian J Ophthalmol 2023; 71:2694-2703. [PMID: 37417107 PMCID: PMC10491055 DOI: 10.4103/ijo.ijo_3330_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/23/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work-place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV-VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV-VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion The findings clearly delineate the at-risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data-driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB.
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Affiliation(s)
- Anahita Kate
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Supriya Sharma
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Cornea and Anterior Segment Services, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India
| | - S Yathish
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Anthony Vipin Das
- Department of Eye Smart EMR and AEye, Indian Health Outcomes, Public Health and Economics Research Center, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nikhila Malepati
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pragnya R Donthineni
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sharon D’Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Swapna S Shanbhag
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Akgun Z, Selver OB. Epidemiology and etiology of chemical ocular injury: A brief review. World J Clin Cases 2023; 11:1245-1251. [PMID: 36926138 PMCID: PMC10013112 DOI: 10.12998/wjcc.v11.i6.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 11/19/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Chemical ocular injury is one of the common ophthalmologic emergencies that can cause vision loss and serious complications. Despite all protective measures, it continues to be a serious public health problem, especially in young male patients. Although it is known that injuries occur most frequently in the workplace and in young male patients, there is a variable frequency and distribution in different regions around the world. In addition, with the coronavirus disease 2019 pandemic, there are changing trends in ocular chemical injuries. This review aims to specify an update on the epidemiological and etiological features of ocular chemical injuries.
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Affiliation(s)
- Zeynep Akgun
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir 35100, Turkey
| | - Ozlem Barut Selver
- Department of Ophthalmology, Ege University Faculty of Medicine, Izmir 35100, Turkey
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Tian B, Zeng L, Lin L, Lao HY, Xu Y, Zhang Y, Ou Z, Zhou J, Yi Y, Chen M, Gu J. Pediatric Chemical and Thermal Ocular Injuries Requiring Hospitalization in South China. Semin Ophthalmol 2022:1-7. [DOI: 10.1080/08820538.2022.2140012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Bishan Tian
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Liangbo Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Lixia Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Hubert Yuenhei Lao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuwei Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuying Zhang
- Department of Ophthalmology, Guangdong Women and Children Hospital, Guangzhou, China
| | - Zhancong Ou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Jin Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Yuhuan Yi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Miao Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Jianjun Gu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
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Akgun Z, Palamar M, Egrilmez S, Yagci A, Selver OB. Clinical Characteristics and Severity Distribution of Tertiary Eye Center Attendance by Ocular Chemical Injury Patients. Eye Contact Lens 2022; 48:295-299. [PMID: 35580512 DOI: 10.1097/icl.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To report demographic characteristics, types and grades of injury, regional distribution of injury severity, clinical findings, and long-term results of acute ocular chemical burns. METHODS Medical records of patients with chemical burns between 2010 and 2020 who were admitted to Ege University less than 72 hr after the injury were reviewed. Age, gender, cause of the burn, injury severity, initial and final best-corrected visual acuity, surgical intervention, and complications were recorded. The injury severity was graded according to Dua classification. RESULTS A total of 104 patients (137 eyes) were included. The mean age was 42.69±17.39 (7-90) years with a male-to-female ratio of 86:18. The most common causes were home (32.6%) and industrial accidents (45.1%). The causative agent percentages for alkaline, acid, and neutral were 49.0%, 35.5%, and 5.7%, respectively. The percentages of eyes in each grade (1-6) were 16.0%, 16.0%, 15.3%, 16.7%, 17.5%, and 18.2%, respectively. Complications mostly occurred in eyes with grade 2 or higher injuries (83.7%). The relationship between injury grade and limbal stem-cell deficiency was statistically significant (P<0.001). Surgery was mostly needed in grade 4 or higher injuries (44 eyes). CONCLUSION The severity of the burn is one of the most important prognostic factors in chemical burns. It is important to determine the spreading of the regional injury severity beside the global one to predict complication risk of the injuries. In the present study, the injury distribution was homogeneous in all grades. Limbal stem-cell deficiency development took place mostly in grade 5 and 6 burns as expected.
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Affiliation(s)
- Zeynep Akgun
- Department of Ophthalmology, Ege University Hospital, Izmir, Turkey
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Ahmmed AA, Ting DSJ, Figueiredo FC. Epidemiology, economic and humanistic burdens of Ocular Surface Chemical Injury: A narrative review. Ocul Surf 2021; 20:199-211. [PMID: 33647471 DOI: 10.1016/j.jtos.2021.02.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/08/2021] [Accepted: 02/15/2021] [Indexed: 01/23/2023]
Abstract
Ocular surface chemical injury (OSCI) is a common type of ocular emergency that can potentially cause significant and permanent visual impairment. However, the global prevalence, demographic factors, socioeconomic burden, and psychological impact of OSCI have not been well investigated or reported. This review aims to provide a comprehensive overview of these aspects, highlight gaps in the literature, and advocate key strategies in reducing the incidence of OSCI. OSCI was responsible for 0.1-15% of all ocular emergency presentations, with an estimated incidence of 5.1-50 per 100,000 population-year. Young working adult men were the most at-risk group, though high rates of OSCI were also observed in young children in developed countries, especially from detergent pods. Low- and middle-income countries were noted to have higher proportions of assault-related and pediatric OSCI cases, often with more severe presentations. Direct and indirect costs for some hospitalized patients led to loss of all personal and household income after the injury. Emergency department costs in the United States were estimated at $106.7 million over four years and costs of treating long term complications such as glaucoma were estimated to be as high as $93,003 over five years. Significant negative impacts on visual and health-related quality of life and psychological well-being have been reported after injury, with higher rates of anxiety, depression, and psychological distress compared to the general population.
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Affiliation(s)
- Afsara A Ahmmed
- South Bristol Academy, Bristol Royal Infirmary, Bristol, UK; University of Bristol, Bristol, UK
| | - Darren Shu Jeng Ting
- Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK
| | - Francisco C Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle Upon Tyne, UK; Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK.
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