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Long-term management of severe ocular surface injury due to methamphetamine production accidents
Asadolah Movahedan1, Brad M Genereux, Mahshad Darvish-Zargar
1*Cincinnati Eye Institute, Edgewood, KY; †Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL; and ‡Department of Ophthalmology, University of Cincinnati, Cincinnati, OH.
Purpose:
The aim of this study was to report the clinical features and management of patients with ocular surface damage during methamphetamine production accidents.
Methods:
This is a retrospective noncomparative interventional case series of 5 patients with methamphetamine production-related ocular injuries referred to the Cincinnati Eye Institute between 1999 and 2014.
Results:
Four of 5 cases were white young men with severe bilateral ocular injury and extremely poor vision. All except 1 eye (9 of 10) were diagnosed with total or near-total ocular surface failure. Limbal stem cell transplantation was performed in 8 of 10 eyes. Keratolimbal allograft was followed by penetrating keratoplasty in 7 of 10 eyes. Ocular surface stability was achieved in 7 of 10 eyes after keratolimabl allograft. Postoperative visual acuity was better than 20/200 in 4 of 10 of eyes. Keratolimbal graft rejection occurred in 3 of 10 eyes; the rate of rejection of penetrating keratoplasty was also 3 out of 10 eyes.
Conclusions:
Methamphetamine-related accidents can lead to severe bilateral ocular injuries. Although stem cell transplantation procedure success is guarded in most of these patients because of severe conjunctival inflammation and accompanying ocular comorbidities, as well as personality issues, compliant patients can achieve good visual function with ocular surface transplantation and subsequent keratoplasty.