About the tactics of treatment and visual rehabilitation in case of an acute severe alkaline burn injury of the eye. A case report

ABSTRACT Purpose. To acquaint ophthalmologists with tactics of treatment of a victim with an acute severe chemical burn injury of the eye i n one of follow-up cases fr om practice. Material and methods. The female patient of 31 years old had a severe alkaline burn injury with total limbal stem cell deficiency in the right eye. до (до After an emergency aid an ischemia of a limbus zone, a total corneal erosion and its moderate edema, a deepithelization of conjunctiva up to the fornices were observed. Visual acuity was 0.3 (before the burn it was 1.0). At 8 days after the burn the covering of ocular surface structures without epithelium was performed using a fresh amnion transplant which edges were sutured closely to the edges of intact bulbar conjunctiva. The total epithelization of the ocular surface (including the cornea) was noted at 39 days after the operation. Visual acuity was 0.2. One year later the visual acuity was 0.07 and the total fibrovascular pannus with the effects of corneal epitheliopathy was detected. The сonjunctival limbal autograft was carried out. Six months later the visual acuity w as 0.9. Conclusion. During the early periods of ocular burn disease with the total limbal stem cell deficiency, the covering of the ocular surface using amnion in a variant of conjunctival plasty reduced the healing time, stabilized the condition of the corneal stroma after the burn, prevented the corneal opacity and an inevitable vascular in-growth creating favorable conditions for the limbal stem cell transplantation