- Design
- Retrospective observational case series, single tertiary centre
- Population
- 20 eyes of 18 patients with carbide gun thermochemical burns, median Dua grade III
- Primary outcome
- Visual acuity, epithelialisation, pain and complications after early amniotic membrane transplantation
- Effect
- logMAR 1.77 to 0.77 at 3 months; all epithelialised; repeat membrane in 21%
Carbide guns, improvised devices that explode, cause burns around Diwali. This retrospective series from a tertiary Indian centre included 20 eyes of 18 patients (mean age 20, all male). All had immediate irrigation, standard medical therapy and then overlay amniotic membrane transplantation. The median injury grade was III on Dua's classification.
Mean acuity improved from logMAR 1.77 to 0.77 at three months. All eyes epithelialised completely, at a mean of 22.5 days. Pain scores fell from 6.05 to 1.16. Repeat transplantation was needed in 21% of eyes. Scarring complications were infrequent and none developed secondary glaucoma. One eye with delayed presentation progressed to phthisis bulbi.
There was no comparison group, so the series cannot show that the membrane caused the recovery. It does suggest that early presentation, irrigation and prompt referral for a membrane are worth planning for before the festival season.
- Warn patients and families about carbide gun injuries in the festival season.
- Irrigate immediately and refer within hours for any significant burn.
- Consider early amniotic membrane transplantation for moderate to severe grades at a centre that offers it.
- Arrange follow-up for scarring, pressure and repeat membrane needs.
- Recognise that delayed presentation was linked to the worst outcome.
Why it matters
These injuries cluster around a predictable festival, so preparation is possible.
Don't overread it
A retrospective series of 20 eyes with no comparison group; it does not show that the membrane is better than medical therapy alone.
The statistics, in plain English
The improvement from logMAR 1.77 to 0.77 is about 10 lines of acuity, but with no control group some of that recovery would have occurred anyway. Averages hide the one eye that ended in phthisis.
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