Severe Ocular Burns
European Ophthalmic Review(2011)
摘要
The worst ocular lesions are chemical burns caused by strong bases and acids. Associated with the destruction of limbal stem cells (LSCs), there are repeated epithelial ulcerations, chronic stromal ulcers, deep stromal neovascularisation, conjunctival invasion and even corneal perforations. The initial clinical examination is difficult because the symptomatology is severe, but nevertheless it helps to classify the lesions, to establish a prognosis and to guide the therapeutic care. The classification system used most is that implemented by Hughes and modified by Roper-Hall. It is now completed neatly by those proposed by Dua and Wagoner, which are based on the importance of the deficit of LSCs. Prognosis of severe forms has progressed significantly thanks to a better knowledge of the physiology of the cornea’s epithelium. Surgical techniques to repair destroyed LSCs have changed the prognosis of severe corneal burns significantly. To limit the incidence of burns, prevention, especially in the industrialised world, is essential.
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