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TitelReversible limbal ischemia and complete re-epithelialization after bilateral ammonia burn
DoelTo report the clinical course of a severe bilateral ammonia burn with near-circumferential limbal ischemia, followed by limbal reperfusion and complete corneal re-epithelialization.
MethodesA 22-year-old woman sustained bilateral ocular ammonia exposure. Following initial irrigation at a local hospital, she was referred to our tertiary ophthalmology centre the following day and admitted for intensive treatment. Serial slit-lamp examinations documented the evolution of corneal epithelial defects, limbal ischemia and revascularization. Treatment included intensive topical corticosteroids, antibiotics, autologous serum and insulin, together with systemic doxycycline and vitamin C.
ResultatenInitial examination revealed 360° corneal epithelial defects and Descemet folds without visible limbal ischemia. By day 6, near-circumferential bilateral limbal ischemia with early conjunctivalization and fibrinous conjunctival membranes had developed despite intensive treatment. From day 10, progressive limbal reperfusion and revascularization were observed, accompanied by progressive epithelial healing. The corneal epithelium was completely closed OS by day 15 and OD by day 19. At discharge on day 21, both eyes had an intact epithelium and a smooth corneal surface. Descemet folds had resolved and visual acuity was improving.
ConclusieThis case demonstrates that even near-circumferential limbal ischemia following severe ammonia injury may be at least partially reversible, with subsequent revascularization and complete corneal re-epithelialization. Recognition of potentially reversible limbal ischemia may be important when assessing prognosis after severe chemical ocular injury.
BelangenverstrengelingNee
Auteurs 1
NaamKEYTSMAN
InitialenE
InstituutUZ Brussel
StadJette
Auteurs 2
NaamSalman
InitialenS A
InstituutUZ Brussel
StadJette
Auteurs 3
NaamKrolo
InitialenI
InstituutUZ Brussel
StadJette
Auteurs 4
NaamNi Dhubhghaill
InitialenS
InstituutUZ Brussel
StadJette
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