Chemical Burns of the Eye: The Role of Retinal Injury and New Therapeutic Possibilities

Cornea. 2018 Feb;37(2):248-251. doi: 10.1097/ICO.0000000000001438.


Purpose: To propose a new treatment paradigm for chemical burns to the eye - in the acute and chronic phases.

Methods: Recent laboratory and clinical data on the biology and treatment of chemical burns are analyzed.

Results: Corneal blindness from chemical burns can now be successfully treated with a keratoprosthesis, on immediate and intermediate bases. Long term outcomes, however, are hampered by early retinal damage causing glaucoma. New data suggest that rapid diffusion of inflammatory cytokines posteriorly (TNF-α, etc) can severely damage the ganglion cells. Prompt anti-TNF-α treatment is markedly neuroprotective. Long term profound reduction of the intraocular pressure is also vital.

Conclusion: A new regimen, in addition to standard treatment, for severe chemical burns is proposed. This involves tumor necrosis factor alpha (TNF-α) inhibition promptly after the accident (primarily for retinal neuroprotection), prophylactic maximal lowering of the intraocular pressure (starting immediately), and keratoprosthesis implantation in a later quiet state.

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Burns, Chemical / drug therapy*
  • Burns, Chemical / surgery*
  • Carbonic Anhydrase Inhibitors / therapeutic use
  • Cytokines / metabolism
  • Humans
  • Infliximab / therapeutic use
  • Keratoplasty, Penetrating / methods
  • Neuroprotective Agents / therapeutic use
  • Retina / injuries*
  • Retinal Diseases / drug therapy*
  • Retinal Diseases / surgery*
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors


  • Anti-Inflammatory Agents
  • Carbonic Anhydrase Inhibitors
  • Cytokines
  • Neuroprotective Agents
  • Tumor Necrosis Factor-alpha
  • Infliximab