[A new treatment concept for severe caustic and thermal burns of the eyes]

Abstract

Combined surgical and drug therapy has proved efficacious in the treatment of severe eye burns. Initially, necrotic epibulbar tissue is excised. The sclera, denuded over a large area and in many cases ischemic, is covered with tenon flaps, prepared and advanced from the undamaged parabulbar connective tissue. For several months, artificial epithelium is used to protect the denuded and to a large extent acellular corneal stroma. Subsequently drug therapy, including corticosteroids, Healon, and prostaglandin synthesis inhibitors, is instituted to reduce the inflammatory reaction of the burned anterior segment. Regeneration of the conjunctival and later also the corneal epithelia may be improved by epidermal growth factor, autologous fibronectin, and proteinase inhibitors (Trasylol). This therapy avoids some complications which could not previously be influenced, and creates more favorable conditions for later corneal grafts.