[A new treatment concept in severe caustic injuries and burns of the eye]

In severe burns of the eye the combination of surgical and drug therapy has proved to be useful. Initially, necrotic epibulbar tissues were excised. Large areas of denuded and in many cases ischemic sclera were covered with Tenon flaps, which were prepared and advanced from the parabulbar undamaged connective tissue. For several months an artificial epithelium was used to protect the denuded and to a large extent acellular corneal stroma. Subsequently, drug therapy including corticosteroids, Healon and prostaglandin synthesis inhibitors was applied to reduce the inflammatory reaction of the burned anterior eye segment. Regeneration of the conjunctival and the corneal epithelia can be improved by epidermal growth factor, autologous fibronectin and proteinase inhibitor (Trasylol). This therapy avoids some of the complications that could not be managed up to now and thus provides more favorable conditions for corneal grafts later.