{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:35:34Z","timestamp":1787758534083,"version":"build-2784847793"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Alkali injuries are ocular emergencies that require immediate evaluation and therapy to preserve vision. Severe alkali injuries can result in long-term vision-threatening sequelae including symblepharon, corneal ulceration, corneal scarring, limbal stem cell deficiency, xerophthalmia, cicatricial changes of the eyelid and adnexa, glaucoma, uveitis, and permanent vision loss. Treatment is aimed at neutralizing the pH, controlling inflammation, and restoring the ocular surface. Here, we present the case of a 35-year-old male who sustained direct ocular exposure to sodium hydroxide, resulting in significant corneal and conjunctival epithelial defects despite aggressive initial medical therapy. The patient subsequently received a large, externally sutured amniotic membrane (AM) with a customized symblepharon ring to promote healing. The corneal and conjunctival defects resolved, and at 4 months after the initial injury, the patient's visual acuity had improved to 20\/25. Clinicians should be aware of the various surgical techniques to place an AM transplantation and identify the best strategy based on clinical findings and the extent and severity of the injury.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/2211-5056.362597","type":"journal-article","created":{"date-parts":[[2022,12,2]],"date-time":"2022-12-02T04:58:59Z","timestamp":1669957139000},"page":"101-105","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Severe ocular alkali injury managed with an externally sutured amniotic membrane and customized symblepharon ring"],"prefix":"10.4103","volume":"13","author":[{"given":"Sophia S.","family":"Lam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonnie A.","family":"Sklar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marisa","family":"Schoen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Rapuano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-18-20240830","doi-asserted-by":"crossref","first-page":"83","DOI":"10.4103\/0974-620X.116624","article-title":"Ocular chemical injuries and their management","volume":"6","author":"Singh","year":"2013","journal-title":"Oman J Ophthalmol"},{"key":"R2-18-20240830","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1001\/jamaophthalmol.2016.2645","article-title":"Epidemiologic trends of chemical ocular burns in the United States","volume":"134","author":"Haring","year":"2016","journal-title":"JAMA 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burns","volume":"90","author":"Prabhasawat","year":"2007","journal-title":"J Med Assoc Thai"},{"key":"R8-18-20240830","doi-asserted-by":"crossref","first-page":"58","DOI":"10.4103\/ijo.IJO_2252_19","article-title":"Amniotic membrane transplant in acute ocular surface burns in Western India: A tertiary eye care center study","volume":"69","author":"Parmar","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"R9-18-20240830","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/j.1442-9071.2006.01408.x","article-title":"Amniotic membrane transplantation for ocular surface reconstruction: Indications and outcomes","volume":"35","author":"Maharajan","year":"2007","journal-title":"Clin Exp Ophthalmol"},{"key":"R10-18-20240830","doi-asserted-by":"crossref","first-page":"1963","DOI":"10.1016\/j.ophtha.2005.05.022","article-title":"Evaluation of amniotic membrane transplantation as an adjunct to medical therapy as compared with medical therapy alone in acute ocular 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costs","volume":"41","author":"Zhou","year":"2022","journal-title":"Cornea"},{"key":"R17-18-20240830","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.jtos.2015.07.002","article-title":"A novel technique for amniotic membrane transplantation in patients with acute Stevens-Johnson syndrome","volume":"14","author":"Ma","year":"2016","journal-title":"Ocul Surf"},{"key":"R18-18-20240830","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.jtos.2019.03.001","article-title":"Sutureless amniotic membrane transplantation with cyanoacrylate glue for acute Stevens-Johnson syndrome\/toxic epidermal necrolysis","volume":"17","author":"Shanbhag","year":"2019","journal-title":"Ocul Surf"}],"container-title":["Taiwan Journal of 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