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The Efficacy of Calcium Gluconate in Ocular Hydrofluoric Acid Burns

Author: Beiran, I : Miller, B : Bentur, Y

Journal: Hum-Exp-Toxicol. 1997 Apr; 16(4): 223-8

Abstract:

  1. Although calcium gluconate (CG) is recommended in the treatment of hydrofluoric acid (HF) eye burn its efficacy seems to be controversial, and controlled human or animal studies are limited. The study’s objective is to compare the efficacy of 1% CG and normal saline irrigation for the treatment of HF eye injury in animals.
  2. 0.05 ml 2% HF was instilled to anesthetized rabbit’s eyes. One minute later, four treatment groups were studies: (1) irrigation with normal saline followed by topical antibiotics, corticosteroids and cycloplegics for 48 h (n = 10); (2) irrigation with 1% CG followed by the same topical treatment (n = 9); (3) as group 1 and 1% CG drops over 48 h (n = 10); (4) as group 3, and injection of 1% CG subconjunctivally after irrigation (n = 9).
  3. Corneal erosion area, corneal haziness, conjunctival status, vascularization (pannus) and acidity were assessed before injury, immediately after initial treatment and 1, 2, 7 and 14 days thereafter by slit lamp aided by fluorescein staining.
  4. Conjunctival pH dropped from 6.0-6.5 to 2.5-3 after injury and increased to 6-6.5 after irrigation. Corneal erosion: smaller in groups 2, 3, significantly so at 2 days, but not different at 14 days. Corneal haziness: more severe in group 4, at 14 days, insignificant. Conjunctival damage: significantly worse in group 4 at 2, 7 and 14 days. Pannus appeared in 2-4 eyes in each group.

CONCLUSION: It seems that for HF injury 1% CG did not have any significant advantage over saline irrigation and topical treatment only. It might have some initial and temporary effect on healing process especially that involving erosion. Given subconjunctivally, 1% CG may be toxic and worsens clinical outcome.

Three Army soldiers were on their way to us following an explosion of an improvised device.  The driver had goggles on and suffered extensive facial trauma and all three had eye injuries from the debris that hit them.  We got bilateral Morgan Lenses in all three and flushed each with several liters of LR.  Followed with antibiotics, they were rebandaged and on an emergency air evacuation that evening.  These men were grateful for the care they received.  The technicians and physicians here are thankful that everyone knew what to do to get the lens system set up and running.  I am grateful to you for the opportunity to access the class online and ability to present it shortly after we arrived.  One of the others did have a corneal laceration that we could assess after flushing.  We feel confident that all will have the best outcomes thanks to the Morgan Lens use.


We also had a patient who experienced an electrical explosion (a generator) to his face.  We used Morgan Lenses to irrigate his eyes and sent him on an air evacuation flight to Germany.  He has since returned to duty and is doing well with minimal residual sight loss.                                   

Military Registered Nurse (Active Duty)

MorTan Inc.

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Why Use The Morgan Lens?

The Morgan Lens is used in 90% of hospital emergency departments in the USA and can be inserted in less than 20 seconds. There simply is no other "hands-free" method of eye irrigation. Nothing else frees medical personnel to treat other injuries or to transport the patient while irrigation is underway. Nothing is more effective at treating ocular chemical, thermal, and actinic burns or removing non-embedded foreign bodies, even when the patient's eyes are closed tightly. Its design makes it simple and straightforward to use so minimal training is required.