Evaluation of chronic ocular sequelae in patients with symblepharon caused by ocular burns
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Yao Fu and Chun-Yi Shao. Department of Ophthalmology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China. drfuyao@126.com; wujunshabu@126.com

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Supported by the National Natural Science Foundation of China (No.81770888); the Shanghai Municipal Education Commission: Gaofeng Clinical Medicine Grant Support (No.20161421); the Shanghai Municipal Science and Technology Commission: the Commercialization and Industrialization of Research Findings Project (No.17411963800); Shanghai Pujiang Program (No.18PJD025); Shanghai Jiao Tong University School of Medicine Two-hundred Talent (No.20191914).

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    Abstract:

    AIM: To evaluate chronic ocular sequelae in patients with symblepharon caused by ocular burns and propose an objective grading system. METHODS: This was a retrospective, single-center clinical study. Patients with symblepharon caused by ocular burns at least six months later were assessed. Chronic ocular sequelae were classified into 3 categories (eyelid, conjunctiva, and cornea) and 9 chronic ocular sequelae [friction factors, exposure factors, conjunctival hyperemia, length of symblepharon, scope of adhesion, lacrimal area adhesion, loss of the palisades of Vogt (POV), corneal neovascularization, and corneal opacification]. Each ocular sequela was graded from 0 to 3, depending on the increasing severity. The 9 ocular sequelae were evaluated to obtain the total severity score for each eye. The total severity score was defined as Grade I (1-9), Grade II (10-18), and Grade III (19-27). Moreover, the correlation between the severity of chronic ocular sequelae and visual acuity, surgical strategy, and the prognosis was analyzed, respectively. RESULTS: Cases of 79 eyes with symblepharon caused by ocular burns were included in this study. Of these, 20 (25.32%) were defined as Grade I, 43 (54.43%) as Grade II, and 16 (20.25%) as Grade III. Eyes with a high total severity score had reduced visual acuity, required complicated surgery strategies, and poor prognosis (P<0.001). Multivariate regression analysis showed that the scope of adhesion, corneal opacification, and corneal neovascularization significantly affected visual acuity, surgical strategy, and prognosis (all P<0.001). CONCLUSION: The evaluation of chronic ocular sequelae enabled the development of an objective grading system for patients with symblepharon caused by ocular burns. This grading system can be applied to guide the treatment and predict the prognosis.

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Liang-Bo Chen, Si-Yi Zhang, Chen-Xi Yan, et al. Evaluation of chronic ocular sequelae in patients with symblepharon caused by ocular burns. Int J Ophthalmol, 2020,13(7):1066-1073

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Publication History
  • Received:June 26,2019
  • Revised:March 15,2020
  • Adopted:
  • Online: May 27,2020
  • Published: