Effectiveness of Diphoterine in the Treatment of Ocular Alkali Burns in Workers in a Brazilian Alumina Refinery

Abstract Purpose: To assess ocular findings after alkali burns and the effects of diphoterine (Diphoterine®) on the injured eyes of twenty-three workers in a Brazilian alumina refinery. Participants: Twenty-three of the 1486 workers who had accidental ocular chemical burns were included in this study. Methods: This is a cross-sectional study over twenty-three of the 1486 workers from an Alumina Company who had accidental ocular chemical burns. The workers were frequently trained to immediately rinse thei eyes and skin using diphoterine solutions on the event of exposure to chemical splashes. However, only twenty-two of the twenty-three patients who were exposed in this type of accident, immediately rinsed their eyes and skin with diphoterine solutions after chemical exposure. During ophthalmology consultation, combined corticosteroids and antibiotic eye drops (Moxyfloxacine 0.3% and dexamethasone), preservative-free lubricant eye drops, and 1g daily oral vitamin C were prescribed to all patients. Depending on the presence of de-epithelization and corneal edema, oral doxycycline 100mg twice daily, 1mg/kg oral prednisone, therapeutic contact lenses, and autologous serum eye drops were prescribed. Main Outcome Measures: visual acuity, degree of inflammation, degree of limbal ischemia and deepithelization Results Twenty -two of twenty- three workers who promptly washed their eyes with diphoterine solutionhad no important permanent sequelae and had considerable recovery of vision. One worker who delayed the initial primary care treatment with diphoterine by almost 15 min had permanent corneal opacity and limbal and scleral ischemia, which required further surgeries to improve visual acuity. Two other workers had Autologous Limbal Transplant (CLAU) for Complete improvement of cornea transparency and its visual acuity. Conclusions: Diphoterine, when used during the first few seconds after chemical exposure, may reduce the incidence of sequelae of ocular chemical injury. All patients were reconducted to work with restored vision.