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An Excess of Topical Calcium and Magnesium Reverses the Therapeutic Effect of Citrate on the Development of Corneal Ulcers After an Alkali Injury

Our purpose was to determine whether chelation of Ca2+ and Mg2+ is the mechanism by which sodium citrate inhibits corneal ulceration in the alkali-injured rabbit eye. The right eyes of 60 albino rabbits (2-2.5 kg) were alkali-injured by filling a 12-mm-diameter plastic well placed on the corneal surface with 0.4 ml of 1 N NaOH. After 35 s the alkali was aspirated, and the well was rinsed with physiological saline. Animals were randomly distributed to three treatment groups of equal size. Two drops of the following topical medications were administered on the hour (14 times a day) for 35 days: physiological saline, 10% citrate in saline, and 346 mM Ca2+, 346 mM Mg2+, and 10% citrate in saline. During the experiment, significantly fewer ulcerations occurred in the citrate-treated eyes (5 of 20, 25%) than in the saline-treated eyes (15 of 20, 75%). When ulcerations did develop in the citrated group, they occurred significantly later and were less severe than those in the saline and calcium-magnesium-citrate groups. There was a significant increase in the number of eyes with signs of band keratophy and translucent areas in the calcium-magnesium-citrate group when compared with the other two groups. As in previous studies, sodium citrate significantly inhibited the development of corneal ulcers after alkali injury. The annulment of the favorable effect of citrates on ulceration in the alkali-injured eye by the addition of calcium and magnesium shows that the mechanism of action of citrate is the chelation of these divalent cation.

Author

Haddox-JL; Pfister-RR; Slaughter-SE, Eye Research Laboratories, Brookwood Medical Center, Birmingham, Alabama 35209, USA

Publication

Cornea. 1996 Mar; 15(2): 191-5

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-Once I had an exposure while give a patient a medication through a saline lock.  The syringe backed out slightly and when I gave the med a little push it sprayed into my eyes.  It burned, so I immediately flushed my eyes.  A co-worker instilled a Morgan lens to each eye and ran sterile N.S. and I felt immediate relief.

-A local trauma surgeon and avid woodworker complained of irritation to his eye for several days.  The eye was obviously irritated.  After being examined by an emergency department doctor for a foreign body, and finding none, we irrigated the eye using the Morgan Lens.  The surgeon found the lens to be comfortable, and after irrigation the eye felt better.  Two days later his eye was better without redness or irritation.

-An employee of the hospital where I work had a car battery explode in his face.  An eye irrigation was set up and initiated with the Morgan Lens.  He felt much better and commented on the soothing feeling of the sterile saline irrigation.

Registered Nurse (California)

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.