Begutachtung der chirurgischen Erstversorgung nach experimenteller Verätzung

Background Initial surgical treatment of severe eye burns is important for the long lasting healing period. To look closer at the efficacy of the early surgical treatment and the possible consequences for woundhealing, the surgical interventions were examined in an animal experiment. Materials and Methods The right eye of 20 rabbits each was burned with 1 n NaOH for 30 seconds followed by a surgical treatment 48 hours later. In the first study necrosectomy, tenonplasty, application of an artificial epithelium and blepharoplasty were performed. In a comparable study blepharoplasty was withdrawn and the fornices were prevented from cicatrization by mechanical treatment with blunt spatula. Antiinflammatory depotinjection of Volon A 40 was applicated additionally. After an interval of 4-18 weeks the eyes were examined histologically. Results A higher risk for infections could be observed in eyes which underwent blepharorhaphy. Furthermore proliferative processes and corneal ulcerations were predominant. In contrast to these findings the latter complications could be prevented due to the clinical inspection of the artificial epithelium and described mechanical irritation of the fornices in the second study. Discussion It could be shown that proliferative processes are major complications after severe burns of the eye. Nevertheless the intensity could be minimized by the consequent use of blunt spatula in combination with antiinflammatory therapy. Furthermore it could be demonstrated that the artificial epithelium is an effective tool providing good prognosis for subsequenty planned keratoplasty. To enable necessary postoperativ inspection blepharoplasty should be avoided.