The Efficacy of Sodium Citrate in the Treatment of Severe Alkali Burns of the Eye Is Influenced by the Route of Administration

Abstract

Rabbit corneas subjected to 12 mm, 1 N NaOH alkali burns for 35 seconds were treated with 10% sodium citrate topically or by subcutaneous injections. In the topically treated group, 18.8% of the citrate-treated corneas ulcerated compared to 78.6% of the controls (0.01 > p > 0.001). The ulcers developing in the citrate-treated group were not only statistically fewer but were significantly less severe in degree. Band keratopathy developed in 64.3% of the control eyes but in none of the citrate-treated eyes. Subcutaneous citrate reduced the incidence of ulceration from 75% in the control to 43% in the treated animals. Although this may represent a trend, it is not statistically significant (p = 0.073). Combining the descemetoceles and perforations in the parenterally treated groups yields an incidence of 56% in the controls and 14% in the citrate-treated animals. This significant difference (p = 0.017) clearly shows the greater severity of ulceration in the control group of the subcutaneously treated animals. These results show that sodium citrate has a most favorable effect in the prevention of corneal ulceration and perforation after alkali burns when applied topically.