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KMID : 1235920090010020158
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Medical Journal of Catholoc University of Daegu
2009 Volume.1 No. 2 p.158 ~ p.163
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Chemical Injury of the Eye
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Kim Hyung-Joon
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Abstract
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Chemical injuries of the eye can produce extensive ocular damage resulting in permanent unilateral or bilateral blindness. Important pathophysiological events are firstly, ocular surface injury, repair, and differentiation, secondarily, cornea1 stromal matrix injury, repair, and thirdly, cornea1 and stromal inflammation. It is also important to grade the severity of the damage together with limbal stem cell injury. Medical therapy should be initiated to enhance re-epithelialization and transdifferentiation of the ocular surface and to promote the repair of the cornea1 stromal tissue by increasing collagen production of keratocyte and reducing ulceration controlling inflammation. Understanding of the importance of the ocular surface has been provided variable surgical options for the management of severe chemical injury. Surgical therapy is to remove the necrotic tissue, rapid normalization of an adequate limbal microenvironment by limbal transplantation. Limbal stem cell transplantation may prevent the development of fibrovascular tissue or sterile ulceration, and improve the long term prognosis. Late rehabilitation of the ocular surface can be achieved, if necessary, by standard penetrating keratoplasty, or by large diameter penetrating keratoplasty. The management of chemical injuries of the eye depends upon a better understanding of the three major pathophysiological processes of chemical injury.
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KEYWORD
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Chemical injury, Ocular surface, Stem cell, Limbal transplantation, Keratoplasty
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