alpha-chymotrypsin and Conjunctivitis

Topics: Accommodation, Ocular; Animals; Chlorpromazine; Chymotrypsin; Conjunctiva; Conjunctivitis; Cornea; Drug-Related Side Effects and Adverse Reactions; Eye Diseases; Eyelids; Glaucoma; Humans; Iatrogenic Disease; Lens, Crystalline; Phenothiazines; Refractive Errors

We describe the clinical history, histopathology and treatment of a two and a half year old boy. He presents with a chronic, unilateral and (pseudo) membranous conjunctivitis, preceded by ear-nose-throat problems and arthritis. The case was considered to be a ligneous conjunctivitis. Treatment consisted of repeated removal of the membranes, combined with topical hyaluronidase, alpha-chymotrypsin, cyclosporin, heparin and antibiotics, and was deceiving.

Topics: Anti-Bacterial Agents; Child, Preschool; Chronic Disease; Chymotrypsin; Conjunctivitis; Cyclosporine; Diagnosis, Differential; Heparin; Humans; Hyaluronoglucosaminidase; Male

Ligneous conjunctivitis is a rare acute or subacute membranous conjunctivitis of unknown etiology for which no generally accepted form of treatment is available.. Between 1972 and 1993, 17 patients with ligneous conjunctivitis were treated with excision biopsy, meticulous hemostasis, and immediate, intensive topical treatment with heparin, steroids, and, in 12 patients, alpha-chymotrypsin until all signs of conjunctival inflammation had subsided.. On histologic examination, the lesions consisted of subepithelial deposits of fibrin in all patients. Eight patients had no recurrence (mean follow-up, 33.1 months) and in four patients the conjunctivitis was controlled after one repeat excision and topical treatment (mean follow-up, 40.3 months). One patient had three recurrences before responding to treatment (follow-up, 24 months). In four patients, treatment was unsuccessful, although lesion-free intervals were longer than usually seen in this condition (mean, 7.8 months).. These results suggest that intensive and early use of topical heparin may improve therapy results in ligneous conjunctivitis.

Topics: Acute Disease; Administration, Topical; Adolescent; Adult; Aged; Biopsy; Child; Child, Preschool; Chymotrypsin; Combined Modality Therapy; Conjunctiva; Conjunctivitis; Drug Therapy, Combination; Female; Fibrinolytic Agents; Follow-Up Studies; Glucocorticoids; Heparin; Humans; Infant; Male; Membranes; Middle Aged; Ophthalmic Solutions; Recurrence; Retrospective Studies; Treatment Outcome

A 45-year-old man who had uneventful excision of bilateral pingueculae developed bilateral membranous lesions involving the bulbar conjunctivae and corneas. Histologically, the membranes were composed mainly of large fibrinous deposits intermixed with acute and chronic inflammatory cells with areas of fibroblastic and capillary proliferation resembling granulation tissue. By electronmicroscopy the amorphous acidophilic masses were composed of electron-dense, fibrillar material with a periodicity of 10-12 mm, which was consistent with fibrin. Despite mechanical removal of the membranes, they continued to recur rapidly over a period of several months. The lesions apparently responded slowly to topical enzymatic therapy that consisted of hyaluronidase (175 U/ml) and alpha-chymotrypsin (1:5000) drops. Follow-up examination, approximately 1 year after surgery, revealed that the patient was asymptomatic. Ocular examination disclosed slight persistence of gelatinous membranes on the bulbar conjunctivae, most prominent in the left eye.

Topics: Adipose Tissue; Chymotrypsin; Conjunctival Diseases; Conjunctivitis; Granulation Tissue; Humans; Hyaluronoglucosaminidase; Male; Middle Aged; Postoperative Complications

Ligneous conjunctivitis occurred unilaterally in a 74-year-old man after pterygium excision and only involved the bulbar conjunctiva. Histochemical studies confirmed the presence of mucopolysaccharides in the lesion sensitive to hyaluronidase. The patient was treated successfully with topical hyaluronidase and alpha-chymotrypsin, with no recurrence 20 months after cessation of therapy.

Topics: Adrenal Cortex Hormones; Aged; Anti-Bacterial Agents; Chymotrypsin; Conjunctivitis; Debridement; Humans; Hyaluronoglucosaminidase; Male; Ophthalmic Solutions; Postoperative Complications; Pterygium; Recurrence

Topics: Child; Child, Preschool; Chymotrypsin; Conjunctivitis; Drug Therapy, Combination; Epithelial Cells; Epithelium; Female; Histocytochemistry; Humans; Hyaluronoglucosaminidase; Infant; Infant, Newborn; Male; Membranes; Metabolism, Inborn Errors; Microscopy, Electron; Staining and Labeling

Topics: Child, Preschool; Chymotrypsin; Conjunctivitis; Female; Humans; Hyaluronoglucosaminidase; Sex Factors

Topics: Biopsy; Child, Preschool; Chymotrypsin; Conjunctivitis; Female; Glycosaminoglycans; Histocytochemistry; Humans; Hyaluronoglucosaminidase; Infant, Newborn; Male

Topics: Anesthesia, Spinal; Anti-Bacterial Agents; Antineoplastic Agents; Antiviral Agents; Argyria; Blindness; Chymotrypsin; Conjunctivitis; Cortisone; Drug Eruptions; Drug Hypersensitivity; Drug-Related Side Effects and Adverse Reactions; Epinephrine; Eye Diseases; Glaucoma; Humans; Intraocular Pressure; Lacrimal Duct Obstruction; Miotics; Mydriatics; Ophthalmic Solutions; Optic Neuritis; Retinal Detachment; Vasoconstrictor Agents

Topics: Child, Preschool; Chymotrypsin; Conjunctivitis; Female; Humans; Hyaluronoglucosaminidase; Infant, Newborn; Male; Ophthalmic Solutions

Topics: Atrophy; Child; Chondroitin; Chymotrypsin; Conjunctivitis; Corneal Opacity; Eyelids; Female; Glycosaminoglycans; Humans; Hyaluronic Acid; Hyaluronoglucosaminidase; Middle Aged; Mucous Membrane; Mucus

Topics: Child; Chymotrypsin; Conjunctivitis; Electrocoagulation; Female; Humans; Hyaluronoglucosaminidase

Topics: Chymotrypsin; Conjunctivitis; Eyelid Diseases; Hyaluronoglucosaminidase; Ophthalmic Solutions

Topics: Chymotrypsin; Conjunctivitis; Hematologic Tests; Humans; Syndrome