Tacrolimus Eye Drops in Treatment of Ocular Alkali Burns / 中山大学学报(医学科学版)

ABSTRACT

[Objective]To evaluate the efficacy of topical use of 1 g/L tacrolimus eye drops in the treatment of ocular alkali burns.[Methods]A prospective study was performed to evaluate the efficacy of 1 g/L tacrolimus eye drops in the treatment of 12 patients with ocular alkali burns admittedin Zhongshan Ophthalmic Center of Sun Yat-sen University between May 23,2016 and Jan-uary 18,2017. The patients were treated for 1 ~ 18 weeks,with an average of 8.91 ± 5.56 weeks.The degree of ocular alkali burns was evaluated according to Roper-Hall classification system. In this group of patients,there were 2 cases of gradeⅡburns,5 cases of gradeⅢburns and 5 cases of gradeⅣburns. Each patient was given 1 g/L tacrolimus eye drops 2 times a day after admission. The slit lamp microscope and corneal fluorescein sodium staining examination were performed before and 1th week,2nd week,3rd week, 4th week,6th week,8th week respectively after performing topical tacrolimus treatment. Photos were taken to keep records to dynami-cally observe the epithelial repair and anterior segment lesions. Adobe Photoshop CS6 image processing software was used to calculate the area of corneal epithelium repair. The therapeutic effect was evaluated according to the corneal epithelial repair ,visual acuity and complications. The statistical analysis was carried out by SPSS 19.0 software.[Results]4 cases reached good prognosis ,including 2 cases of gradeⅡ and 2 cases of gradeⅢ burns,the corneal epithelium healed and the visual acuity was greater than 0.3. 5 cases had guarded prognosis,including 3 cases of gradeⅢand 2 cases of gradeⅣburns,corneal epithelium healed in 2 cases,corneal epi-thelial repair rate was greater than 50%in 3 cases,in which corneal neovascularization or corneal conjunctiva occurred,and the visu-al acuity was less than 0.3. 3 cases of gradeⅣ burns had poor prognosis1 had corneal perforation,1 had long term corneal ulcer, and 1 had secondary glaucoma. In 12 cases,the corneal epithelial healing rate reached 99% in 50% patients,and the healing rate was greater than 50%in 75%patients. The visual acuity of 33.3%patients increased by more than three lines,and 66.6%cases had complications. The main factors affecting the prognosis areThe degree of corneal and corneal limbal burns,complication and corneal epithelial repair rate.[Conclusion]1 g/L tacrolimus eye drops can reduce the inflammatory reaction of ocular alkali burns ,reduce the incidence of glaucoma,promote corneal ulcer healing and corneal epithelial repair,and reduce complications caused by corneal lim-bal burns.