Citrate or ascorbate/citrate treatment of established corneal ulcers in the alkali-injured rabbit eye.
Immediate treatment of alkali-injured eyes with citrate or ascorbate has previously been shown to prevent corneal ulceration and perforation in the rabbit. Other experiments showed that while ascorbate treatment of established ulcers did not appear to lead to significant healing it did reduce perforations by prolonging the presence of descemetoceles. In the present experiment with established ulcers, alkali injuries were created with 1 N NaOH in a 12 mm corneal well for 35 seconds. Eyes were entered into the study with anterior, middle or posterior ulcers. When compared to controls, 10% citrate (q1/2 hr) significantly reduced the deepening of anterior stromal ulcers while 10% ascorbate/10% citrate (q1 hr/q1 hr-30 min apart) showed only a trend toward reduction of these ulcers (14 hr of dropping). The demonstration of healing (total vascularization or no ulcer) is significant when comparing the control group (8.3%) to the citrate treated group (58.3%, 0.01 less than P less than 0.009), but not the ascorbate/citrate group (18.2%). Sixty-seven percent of anterior stromal ulcers in the control group progressed to descemetocele or perforation, compared to 8.3% in the citrate treated (0.003 less than P less than 0.004), and 45.5% in the ascorbate/citrate treated group (not significant). While the numbers of ulcers entered as middle stromal were too few to analyze statistically, the reduced numbers of perforations and increased stability prior to perforation in both treatment groups suggest a positive effect by both citrate and ascorbate/citrate. Treatment of posterior stromal ulcers did not prevent the development of descemetoceles and perforations in either treatment group; however, the numbers in this category were too few to analyze.(ABSTRACT TRUNCATED AT 250 WORDS)