Verätzungen des Auges können aufgrund einer Dysregulation inflammatorischer Reaktionen zu
schweren Gewebeschäden des Augapfels mit kornealer Fibrogenese und Erblindung sowie zur
Vernarbung der Lider und der ableitenden Tränenwege führen. Augenverätzungen gelten
deshalb als Notfälle höchster Dringlichkeit, wobei die frühzeitige intensive
Spülbehandlung die wichtigste Sofortmaßnahme bildet.
Abstract
Chemical burns of the ocular surface (CBOS) are emergencies of highest urgency.
Therefore, an adequate emergency care is mandatory. Following a precise analysis of the
initial damage, a staged therapeutic approach is used to prevent persistent impairment of
the ocular surface. In the acute stage, the prevention of complications is targeted
(symblepharon, conjunctival scarring, lacrimal stenosis, corneal ulceration, intraocular
inflammation, elevated intraocular pressure, etc.). In later stages, if complications have
developed, a secondary restoration of the ocular surface is focussed. Sometimes this
requires several surgical interventions. Based on a review of international literature,
this review highlights the pathophysiology according to different chemical agents, CBOS
stages as well as main therapy strategies in early and advanced stages of CBOS. Acute
treatment aims to lower inflammation, oxidative stress and tries to promote
reepithelialisation. Besides conjunctival scarring, loss of goblet cells and corneal
opacification a limbal stem cell insufficiency is the most harming complication. Several
new techniques have been developed to recover the ocular surface with a sufficient and
clear epithelial layer in order to avoid neovascularization of the cornea. The knowledge
concerning the high risk potential for persistent visual impairment in CBOS patients and
the ability for appropriate emergency care should be kept in every physicianʼs mind
dealing with CBOS.
