Oxygen Therapy for Acute Ocular Chemical or Thermal Burns: A Pilot Study

PURPOSE: To evaluate the effect of systemic oxygen therapy in the management of acute ocular chemical and thermal burns. DESIGN: Prospective, nonrandomized, comparative, interventional case series. METHODS: Twenty-four eyes of 22 patients with grade III to IV acute ocular chemical and thermal burns received conventional medical therapy. The oxygen therapy group (13 eyes) additionally received 100% oxygen using a simple mask at a flow rate of 10 L/minute for 1 hour twice daily. Main outcome measures were time for healing of the corneal epithelial defect and improvement in perilimbal ischemia. Secondary outcome measures included visual acuity, corneal transparency and vascularization, and complications. RESULTS: Corneal epithelial defects healed within 15.23 +/- 3.94 days (range, 10 to 21 days) in the oxygen group versus 59.9 +/- 23.33 days (range, 28 to 95 days) in controls (P<.001). Vascularization of ischemic areas was complete in 14.54 +/- 2.70 days (range, 10 to 21 days) in the oxygen group versus 45.09 +/- 22.20 days (range, 25 to 105 days) in controls (P=.001). In the oxygen group, the cornea was more transparent and less vascularized 3 and 6 months after injury. Mean final visual acuity (logarithm of the minimal angle of resolution) was 0.40 +/- 0.52 (range, 0 to 1.3) versus 1.11 +/- 0.83 (range, 0.1 to 3) in the oxygen and control groups, respectively (P=.018). In the oxygen group, symblepharon or corneoscleral melting did not develop in any patient; however, in the control group, symblepharon developed in 3 eyes and corneoscleral melting developed in 1 patient. CONCLUSIONS: In the acute phase of ocular chemical or thermal burns, oxygen therapy improves limbal ischemia, accelerates epithelialization, increases corneal transparency, and decreases corneal vascularization. It also may improve visual acuity and reduce complications.