The Application of MEBO in the Repair of Alkali Injured Corneal EpitheliumWhen alkali burns on eyes, alkali materials enter eyes and usually rapidly cause corneal epithelium necrosis and disruption that make stroma and intraocular tissue further injury. Therefore, treatment principle should let corneal epithelium smoothly heal as soon as possible to minimize the injury toward intraocular tissue and to avoid complications, such as infection, ulceration, etc. Though already have some experience in how to expedite corneal epithelium healing clinically, the result is not totally satisfied. From 1997, editor had started to add MEBO Burn ointment on the base of traditional therapy, and gained satisfied result. The healing of corneal epithelium including the regeneration of epithelium and the upcoming morphological and functional transformation of epithelial cell at the initial stage.Partial necrosis of the corneal epithelium and the residual corneal epithelium around the lesion in light alkali burns, the regenerated epithelium comes from these residual cells or corneal layer sterm cells, under through reasonable therapy then can smoothly complete the regeneration and finally transform into normal transparent and stable epithelial cells. The cases in this group, there are no obvious differences between two groups of Ⅰ and Ⅱ degree burns cause the injury is milder. However, there are more vasculization, severe inflammatory reaction, lower transparency of regenerated corneal epithelium, containing cuboidal cells and pterygium even angiopoiesis in severe alkali burns, and finally result in abnormality of the ocular structure. The factors that involve the rate of corneal epithelium regeneration are the amount of residual corneal epithelium, the confine of the conjunctiva necrosis and the inflammatory reaction,etc. As the inflammatory occurred will decline the regeneration of the corneal epithelium and decline the integrity between epithelium and the basal layer of the lesion, and the decline of the epithelium transformation will also result in recurrent epithelial erosion even the continuous defect. Especially the inflammatory factors in the post-traumatic 72 hours, the transportation of polymorphonuclear neutrophils will impede the transportation of epithelial cells, the regenerated epithelium cannot use the injured basal membrane, thus, decline the integrity between epithelium and the basal membrane and result in epithelium erosion and disruption. Therefore, it is important to control inflammatory at the early stage in alkali burns. Because the inflammation in alkali burns are mostly non-infectious, besides total or local antibiotics prophylaxis, local physiological moistening and successful drainage can stable the cell membrane and lysosome membrane, thus, decline the release of inflammatory substance and chemokine to relief the inflammation and improve the corneal epithelium regeneration indirectly. The outcome of the 90 eyes of 70 cases in this group that under through the MEBO therapy proved this point. Early conjunctiva sac irrigation not only improves the pH environment but also cleans the necrotic and disrupts tissue; to use artificial tears in order to improve the quality of tears. The data from this group reveals that 88 eyes in 90 eyes successfully complete the corneal epithelium regeneration, lessen time, fewer complications and better vision recovery in comparison of the control cases. The main reason is that MEBO can neutralize and enhance the local microcirculation to improve the epithelialization. Someone reported that MEBO can maintain the physiological moisture and neutralize acid and base, at the same time, can hydrolyze, enzymolysis and combine with toxic substance to disintoxicate.[2] MEBO can avoid interval tissue from necrosis and can reverse the vital tissue as possible that improve the epithelial cells regeneration.[3] MEBO can improve the regeneration of the corneal epithelium in alkali burns, and also the recovery of the vision. Full Report: The Application of MEBO in the Repair of Alkali Injured Corneal Epithelium, The Chinese Journal of Burns Wounds and Surface Ulcers 2001, (3): 163-165 |
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