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Emergency treatment of eye burns: which rinsing solution should we choose?

Abstract

Background

In the treatment of eye burns few data on the comparative application of rinsing solutions exist. We present experiments in vitro and ex vivo on the pH changes that can be achieved in alkali eye burns with currently distributed and propagated rinsing fluids like water, saline solution, Cederroth Eye Wash Solution (including borate buffer), Diphoterine, Ringers lactate solution and phosphate buffer.

Methods

Titration curves in beakers are compared with ex vivo experiments on isolated rabbit eyes. We exposed eyes to burns from filter paper soaked in 2 mol NaOH, continuously measuring the anterior chamber pH by means of a micro pH electrode placed near the endothelium. In each experiment—repeated five times—the corneal burn of 20 s in 2 mol NaOH was followed by a period of 15 min of rinsing under a defined flow of 66 ml/min.

Results

We found highly significant differences in intracameral pH related to different types of rinsing solutions. The return of the intracameral pH to normal was not achieved by any of the rinsing fluids, but the best results were noted for of Cederroth Eye Wash Solution (Cederroth Industrial Products, Upplands Väasby, Sweden) and the Diphoterine- and Previn solutions (Prevor, Cologne, Germany). Water played an intermediate role whereas saline and phosphate buffer were not efficient at lowering intracameral pH after alkali burns.

Conclusion

In alkali burns we recommend efficient buffering solutions. The tested isotonic phosphate buffer (PBS) was not effective at buffering the intraocular pH. Water was found to be much less efficient than Previn, Diphoterine or Cederroth Eye Wash solution in balancing intraocular pH.

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Acknowledgements

The authors wish to thank the Deutscher Akademischer Austauschdienst for the stipendium for clinical and experimental research given to Dr. Rihawi. Furthermore, we would like to thank the Aachen Center of Technology Transfer in Ophthalmology for funding the study in cooperation with the industrial sponsors Cederroth Inc. and Prevor Inc. Rinsing solutions were supplied by the companies Cederroth and Prevor, who also paid for the costs of the materials. There are no proprietary rights or any financial interest in the products named in the article.

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Correspondence to N. F. Schrage.

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Rihawi, S., Frentz, M. & Schrage, N.F. Emergency treatment of eye burns: which rinsing solution should we choose?. Graefe's Arch Clin Exp Ophthalmo 244, 845–854 (2006). https://doi.org/10.1007/s00417-005-0034-3

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  • DOI: https://doi.org/10.1007/s00417-005-0034-3

Keywords

  • Rinsing
  • Emergency
  • Alkali
  • Burn
  • Buffer
  • First aid
  • Amphoters