FIELD: medicine.
SUBSTANCE: type of burn - chemical or thermal - is determined. The overall thickness of the cornea, the thickness of the cornea in the central optical zone, visual acuity is determined. The intensity of corneal epithelium damage zone staining with a vital dye is estimated. Endothelial cells density is determined according to computer keratotopography. The content of endothelial cells with pleomorphism and polymegatism is determined according to confocal microscopy. With a chemical burn with lesions of eyelids and conjunctiva, a decrease in vision to 0.6-0.8, corneal staining - II moderate intensity, a decrease in the cornea thickness in the central optical zone of not more than 25 mcm relative to the norm, reduced total cornea thickness of not more than 30 mcm relative to the norm, endothelial cells density of not more than 2500 cells/mm, polymegatism of not less than 40%, pleomorphism of not more than 35%, sterile solution of 0.9% sodium chloride is used as an irrigation system. With a chemical burn with corneal damage, a decrease in vision to 0.3, corneal staining - III medium intensity, a decrease in the cornea thickness in the central optical zone of not more than 30 mcm relative to the norm, reduced total cornea thickness of not more than 30 mcm relative to the norm, endothelial cells density of not more than 2400 cells/mm, polymegatism of 40-45%, pleomorphism of not more than 40%, a neutral 4.9% buffer solution of phosphate salts is used as an irrigation system. With a thermal burn with eyelids and conjunctiva lesions, a decrease in vision to 0.6-0.8, corneal staining - I low intensity, an increase in the cornea thickness in the central optical zone of not more than 25 mcm relative to the norm, increased the total cornea thickness of not more than 10 mcm relative to the norm, endothelial cells density of no more than 2700 cells/mm, polymegatism of not less than 30%, pleomorphism of more than 50%, sterile 0.9% sodium chloride solution is used as an irrigation system. With a thermal burn with corneal damage, a decrease in vision to 0.6-0.8, corneal staining - II moderate intensity, an increase in the cornea thickness in the central optical zone of not more than 50 mcm relative to the norm, increased total cornea thickness of not more than 20 mcm relative to the norm, endothelial cells density of not more than 2500 cells/mm, polymegatism of not less than 35%, pleomorphism of not more than 40%, neutral 4.9% buffer solution of phosphate salts is used as an irrigation system.
EFFECT: high functional result in the outcome of thermal and chemical burns of the first or second degree, accurate timely diagnosis of the state of the cornea and timely application of optimal clinical conditions of irrigation solutions for emergency care by evaluating the complex of the most significant indicators.
4 ex
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Authors
Dates
2017-10-24—Published
2017-02-14—Filed