Management of alkali burns: An 11-year retrospective review☆
Section snippets
Patients
The RVEEH is a tertiary care ophthalmic hospital serving the state of Victoria, Tasmania, and parts of southern New South Wales, Australia. It has a referral base of approximately 5 million people. More than 20,000 ophthalmic emergencies are assessed each year. A computer search of the medical records for all patients admitted with the diagnosis of alkali, acid, or other burn of the cornea and conjunctival sac, eye, or adnexa (ICD-9-CM diagnostic codes 940.0-9) was performed for the period of
Methods
All patients included in the study were assessed at the RVEEH and had their treatment initiated within 24 hours of injury, although emergency irrigation was usually initiated before referral to the study hospital. All patients received copious irrigation of their injured eye(s) until the pH was documented as neutral and for a minimum of 30 minutes. Criteria for admission included: (1) a grade 2 injury or worse in one eye or (2) a grade 1 injury in a child, mentally handicapped individual, or a
Demographics and nature of injury
The study period was from January 1, 1987, until January 31, 1998. There were 121 patients admitted to the RVEEH with alkali burns (177 eyes). The patient demographics and nature of injury are summarized in Table 2. The number of patients with alkali burns admitted by year varied over the decade from a low of 5 to a high of 31 (Fig 1). Data for the state of Victoria for this period show that 82 of 129 (64%) patients treated in public hospitals for injuries coded as alkali burns were treated at
Discussion
This study describes the spectrum of ocular alkali injuries treated at a large referral hospital and assesses the risks and benefits of adjunctive medical therapy. The study includes most of the serious alkali burns treated in the state of Victoria because the RVEEH treated 64% of all inpatients statewide. Although our review of inpatient records revealed a number of incorrectly categorized burns, our impression is that this series is representative of ocular alkali injuries in Victoria.
The
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Supported by an R. Samuel McLaughlin Foundation Fellowship (SCB), Department of Ophthalmology, Queen’s University, Kingston, Ontario, Canada.