Topical erythropoietin for the management of scleral necrosis after ocular chemical burns

Sepehr Feizi; Fatema Jafari; Sadid Hooshmandi; Hamed Esfandiari

doi:10.1016/j.burns.2024.03.033

Topical erythropoietin for the management of scleral necrosis after ocular chemical burns

Burns. 2024 Apr 4:S0305-4179(24)00113-X. doi: 10.1016/j.burns.2024.03.033. Online ahead of print.

Authors

Sepehr Feizi¹, Fatema Jafari², Sadid Hooshmandi², Hamed Esfandiari³

Affiliations

¹ Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: sepehrfeizi@yahoo.com.
² Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
³ Department of Ophthalmology, Olmsted Medical Center, Rochester, MN, USA.

PMID: 38604821
DOI: 10.1016/j.burns.2024.03.033

Abstract

Purpose: To evaluate the efficacy of topical erythropoietin for chemical burn induced scleral necrosis.

Methods: This study included 18 eyes of 16 patients with chemical burn induced scleral necrosis who presented within 6 weeks of the injury. In the prospective arm, 11 eyes received topical erythropoietin, 3000 IU/mL every 6 h, along with standard medical treatment. Retrospectively, we included 7 consecutive eyes of 7 patients who were managed with conventional treatment as historical control group. The main outcome measure was healing of avascular scleral lesions. The secondary outcome measure was complete re-epithelization of cornea.

Results: Mean patient age was 39.8 ± 16.2 years in the erythropoietin group, and they presented 16.6 ± 15.2 days after acute chemical injury. Scleral necrosis improved in all eyes after 30.7 ± 23.2 days of treatment with topical erythropoietin. Corneal epithelial defects were completely healed in 10 eyes 61.9 ± 50.7 days after the start of the medication. In comparison, standard medical treatment alone did not improve scleral necrosis in the historical control group, necessitating ocular surface reconstruction including conjunctival advancement (1 eye) and tenonplasty (6 eyes).

Conclusion: The results of our study showed that topical erythropoietin was effective in the management of chemical burn induced scleral necrosis. This treatment could avoid ocular surface reconstruction procedures in inflamed eyes.

Keywords: Acute chemical burn; Scleral necrosis; Tenonplasty; Topical erythropoietin.