Volume 03 Issue 01-2023
33
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
I
SSUE
01
P
AGES
:
33-37
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
Chemical burns of the eye occur mainly in the working-age population, and the development of various complications
as a result of non-compliance with international standards in the provision of emergency medical care leads to
disability.
Goals and objectives.
Determination of the effectiveness of photodynamic therapy and complex treatment of chemical
spectacle lenses using biochemical indicators of tears.
Materials and methods.
In 2019 - 2022 110 patients (155 eyes) treated with GKBSMP with a diagnosis of chemical eye
disease of I-II-III degree were divided into 3 groups: in the comparison group - patients who received standard therapy;
the patient of the main group I additionally underwent PDT on the apparatus "Vostok"; in the II main group,
methylethylpyridonol was added to the glass cap.
Quantitative biochemical method for the determination of superoxide dismutase (SOD), catalase (CT),
malondialdehyde (MDA) and slezax.
Research Article
BIOCHEMICAL EVALUATION OF THE EFFICACY OF COMPLEX
TREATMENT OF EYE BURN
Submission Date:
January 20, 2023,
Accepted Date:
January 25, 2023,
Published Date:
January 30, 2023
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume03Issue01-06
Bakhritdinova Fazilat Arifovna
DSc Professor Of The Department Of Ophthalmology, Tashkent Medical Academy, Uzbekistan
Bilalov Erkin Nozimovich
Professor, DSc, Head Of The Department Of Ophthalmology, Tashkent Medical Academy, Uzbekistan
Oralov Bekhruz Abdukarimovich
PhD, Assistant Of The Department Of Ophthalmology, Tashkent Medical Academy, Uzbekistan
Egamberdiyeva Saida Mamadjanovna
Assistant Of The Department Of Ophthalmology, Tashkent Medical Academy, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 03 Issue 01-2023
34
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
I
SSUE
01
P
AGES
:
33-37
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Results and discussion.
In treatments and all groups of treks, the amount of SOD and CT decreases by 1-2 times, and
MDA increases by 3.5 times.
The activity of SOD below 7 was similar to that of PDT by 1.43 times, and in the treatment with methylated pyridinol -
by 1.78 times, it was significantly higher than the comparison group and by 1.06 times. It was found that in patients of
the main group II, activation of CT was 1.25 times, and the level of MDA was significantly reduced by 2.08 and 2.97
times compared with the values before treatment in both groups.
Conclusions.
It has been proven that when using photodynamic therapy and complex treatment of chemical glasses,
activation of the antioxidant system and increased epithelialization of damaged areas of the eye surface are more
effective than with traditional treatment.
KEYWORDS
Chemical burn; photodynamic therapy; superoxidedismutase; catalase; malondialdehyde.
INTRODUCTION
Chemical burns of the eye are urgent cases in
ophthalmology, and these injuries account for up to
22% of eye injuries [1, 5].
In case of a chemical burn of the eye, it is recommende
to immediately wash the eye with a large amount of
water to eliminate the harmful chemical factor, to
remove it and to reduce possible complications [2, 3,
4].
According to standard medical therapy, the focus is on
the use of agents that improve epithelization and
reduce inflammation on the injured surfaces [6, 8].
Cleaning of necrotic tissue, tenonoplasty and
keratoplasty are effective in surgical treatment.
However, since it is not possible to use it everywhere,
it is recommende to use optimal options of
conservative treatment [7, 9, 10].
Many
effective,
etiopathogenetically
oriented
methods of treatment of chemical burns of the eye
have been proposed. Despite the many options
offered, there is no single effective treatment method
that leads to the best results [11]. Given this fact, there
is a need to search for complex methods of treatment
with high clinical efficacy, reducing the number and
degree of complications that develop after chemical
eye burns [12].
Goals and objectives. Improving the complex
treatment of chemical burns of the eye based on
clinical and laboratory data of the lacrimal fluid.
Materials and methods. The object of the study were
110 patients (155 eyes) who were treated with a
diagnosis of chemical burns of the eye of I-II-III degree
from 2019 to 2021 and 12 people (12 eyes) - practically
healthy individuals who made up the control group.
Volume 03 Issue 01-2023
35
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
03
I
SSUE
01
P
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:
33-37
SJIF
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MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Depending on the therapy, the patients were divide
into three homogeneous groups.
In the first (control) group, 37 patients received
traditional therapy according to ophthalmological
standards.
38 patients of the second (main) group on the basis of
traditional therapy received photodynamic therapy
(PDT) on the Vostok laser device in the developed
therapeutic doses of 300 mJ (630 nm, pulsed radiation)
for 3 minutes once a day. The duration of treatment
was 5-7 days, depending on the severity of the burn.
35 patients of the third (main II) group, along with
therapy of the main group I, were added
methylethylpyridinol in the form of eye drops, 1 drop x
3 times a day in the affected eye, for 10 days.
The study used biochemical research methods, in
particular, superoxide dismutase (SOD), catalase (CT),
malondialdehyde (MDA) was determined.
RESULTS AND DISCUSSION
In all patients of the three groups, the initial
biochemical parameters in the lacrimal fluid before
treatment did not differ from each other (p
˃
0.05). At
the same time, in the control group, the amount of
SOD was 6.79 ± 0.89 conventional units / ml, in the
comparison group 3.53 ± 0.79, in I and II main groups
3.62 ± 0.81 and 3.39 ±0.86 respectively. The level of
catalase was 0.17±0.04; 0.16±0.05; 0.18±0.06;
0.16±0.06 µmol/l for the above groups. Both of these
biochemical parameters determined the level of the
antioxidant system of the ocular surface during
inflammatory processes. MDA as an indicator of
inflammation was 1.49±0.29 nmol/ml before treatment
in the control group, and 5.13±1.57 in the other studied
groups, respectively; 5.04±1.40; 5.49±1.69. At this time,
in all three groups, the number of SOD and CT
decreased from 1 to 2 times, and the MDA indicators
increased to 3.5.
On day 7, the low activity of SOD in the lacrimal fluid in
the treatment of eye burn with PDT significantly
increased by 1.43 times (p<0.05), but when it was used
with methyl etidpyridinol, it increased by 1.78 times
(p<0.05), and was higher than the values of the
comparison group by 1.06 and 1.24 times, respectively.
Analysis of catalase activity at the local level during the
complex treatment of eye burns showed a tendency to
its activation by 1.25 times in patients of the main group
II.
In the main group I, this indicator, while maintaining
stability, did not change, and in the comparison group,
it tended to decrease.
In both main groups, the activity of the catalase
enzyme even slightly exceeded that of practically
healthy individuals. Such activation of catalase in SF
contributed to a more pronounced neutralization of
peroxide radicals, which was manifeste by a decrease
in the level of MDA. The level of MDA significantly
decreased by 2.08 and 2.97 times (p<0.05) relative to
the values before treatment in the main groups. We
can see that the values of SOD and MDA are inversely
proportional to each other, that is, in inflammatory
processes, mainly SOD decreased due to an increase in
MDA.
Meanwhile, along with positive shifts in the level of
MDA, this value was still significantly exceede in
relation to the values of practically healthy individuals
by 1.89 and 1.62, 1.24 times, respectively, in the
comparison group and the main groups. These results
indicate the presence of inflammatory processes in the
eye in accordance with their values.
Volume 03 Issue 01-2023
36
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
03
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P
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33-37
SJIF
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(2022:
5.
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)
OCLC
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1121105677
Publisher:
Oscar Publishing Services
Servi
The combined use of PDT and methylethylpyridonol
effectively attenuated the chemical burn-induced
upregulation of angiogenesis-related factors such as
MDA. Since an increased level of MDA has a positive
correlation with the level of oxidative stress and a
decrease in antioxidant status. At the same time, a
correlation was establishe between an increase in the
level of MDA and a decrease in CT, SOD. The presence
of a direct relationship between the imbalance in the
lipid peroxidation system and the buffer system of the
anterior surface of the eye has been confirme,
especially in patients with moderate burns.
CONCLUSION
In the complex treatment of chemical burns of the eye,
a higher efficiency of epithelialization of injured
surfaces has been prove due to the enhancement of
the antioxidant system of the eye surface by
photodynamic therapy compared to traditional
methods of treatment. At the same time, the
effectiveness of the treatment of chemical burns of the
eye is based on the monitoring of biochemical markers
such
as
superoxide
dismutase,
catalase,
malondialdehyde in the lacrimal fluid.
It has been establishe that in the lacrimal fluid of
patients with eye burns, the level of MDA increases,
against the background of a decrease in the activity of
CT and SOD. The use of PDT and methylethylpyridonol
in the complex treatment of patients with eye burns
activates CT, reduces free radicals, improves the
antioxidant system, reduces the high level of MDA and
the degree of endogenous intoxication, and
accelerates the reparative processes of the ocular
surface of post-burn lesions. The antioxidant effects of
methylethylpyridinol resulted in increased secretion of
a native antioxidant enzyme such as SOD, which
neutralizes toxic free radicals produced during
inflammation.
Based on the results obtained, an algorithm for the
complex treatment of chemical eye burns was
develope.
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