Elsevier

Ophthalmology

Volume 117, Issue 12, December 2010, Pages 2268-2272
Ophthalmology

Original article
Clinical Characteristics and Visual Outcome of Severe Ocular Chemical Injuries in Shanghai

https://doi.org/10.1016/j.ophtha.2010.03.050Get rights and content

Objective

To study the clinical characteristics of patients with severe ocular chemical injury in Shanghai and to determine their relationship with visual outcome.

Design

Retrospective case series.

Participants

A total of 79 525 in-patients at Shanghai Eye, Ear, Nose, and Throat Hospital between 1998 and 2008.

Methods

Medical records of severe ocular chemical injuries were reviewed retrospectively. Patients' age, gender, occupation, location where injury occurred, the nature of chemical agent, complication, and visual acuity at final follow-up were described. The relationship between visual impairment and clinical characteristics was analyzed.

Main Outcome Measures

Estimated prevalence rate, demographics of patients, nature of injury, prognosis, and factors associated with visual impairment.

Results

The estimated prevalence rate in Shanghai of severe ocular chemical injury was 1.58 per 100 000. One hundred ninety cases with 239 eyes were identified for analyzing the clinical characteristics. The average age of all subjects was 35.3±14.8 years with a male:female ratio of 6:1. Factory and construction worker (n = 141; 74.2% of total cases) were the most common occupations. Most of the accidents occurred at workplace (n = 144; 74.8%); the majority of injuries were caused by alkali agents (n = 129; 67.9%). Complications were found in 222 eyes (92.9%). A visual acuity of ≥6/60 was achieved only in 5 eyes (2.1%). In multivariate logistic regression analysis, being visually impaired was significantly associated with the patients' complication (P = 0.021).

Conclusions

The prevalence of severe ocular chemical injury in Shanghai is low. Most subjects needed surgery to restore visual function. Successful management provides a good prognosis for most patients.

Financial Disclosure(s)

The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Section snippets

Methods

We reviewed the medical records of patients in our unit from 1998 to 2008. The Medical Ethics Committee of Shanghai Eye, Ear, Nose, and Throat Hospital approved the study protocol.

Severe ocular chemical injury was defined as any person sustaining an injury with9 total loss of the corneal epithelium, corneal haziness obscuring iris detail or worse, and over 120° of limbal ischemia. These findings equate to grades 3 or 4 on the Hughes–Roper–Hall classification scale. All patients included in the

Shanghai Prevalence Rate of Severe Chemical Corneal Injury

During the study period, the Shanghai Ocular Chemical Injury Study (SOCIS) used a reporting base of approximately 79 525 medical records. From 1998 to 2008 inclusive, the SOCIS received 357 reports of patients with ocular chemical injury. Of these, 72 did not meet the inclusion criteria, and 95 injured <1 month before the end of the collection period. Therefore, there were 190 patients who were suitable for multivariate logistic regression analysis for potential factors associated with visual

Discussion

Eye injury is a major cause of blindness in China.10 The annual incidence of eye injury in Hong Kong is estimated to be approximately 125 cases per 100 000 people.11 Although ocular chemical injuries are considered to account for a significant percentage of eye injury, little information is available concerning the risk factors. Thus, determination of these risk factors has important public health implications. However, information about the epidemiology, clinical characteristics, management

References (17)

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Manuscript no. 2009-1525.

Financial Disclosure(s): The authors have no proprietary or commercial interest in any of the materials discussed in this article.

Supported by grants from the Key Clinic Medicine Research Program, the Ministry of Health, China (2007–2009); Shanghai Excellent Leading Scholars Program, Science and Technology Commission of Shanghai Municipality, Shanghai (10XD1401100); Outstanding Doctoral Research Program Fudan University (2009–2011). The sponsor or funding organization had no role in the design or conduct of this research.

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