alpha-chymotrypsin and Hemorrhage

One hundred eyes undergoing intracapsular cataract extraction and 100 undergoing extracapsular extraction were examined prospectively within one week postoperatively and again at 6-10 weeks postoperatively. Indirect ophthalmoscopy showed vitreous haemorrhage in 36% of the intracapsular group and 13% of the extracapsular group. Vitreous haemorrhage was significantly related to the occurrence of operative hyphaema (p less than 0.01) but not to iridectomy (p greater than 0.05). In the intracapsular group the use of chymotrypsin significantly reduced the incidence of vitreous haemorrhage (p less than 0.01). Three different types of vitreous haemorrhage were identified--streaks, diffuse haze, and beads in the vitreous base. Wound haemorrhage and operative hyphaema account for most cases, but it is suggested that zonular traction may be responsible for the bead haemorrhages and also for the retinal haemorrhages reported by other authors. Although no difference in visual result or incidence of cystoid macular oedema was observed in this study, a relationship to the vitreoretinal pathology of aphakia is suggested.

Topics: Adolescent; Adult; Aged; Cataract Extraction; Child; Chymotrypsin; Hemorrhage; Humans; Hyphema; Middle Aged; Postoperative Complications; Vitreous Body

The authors report on the results of a comparative study on vitreous loss in connection with cataract surgery before and after the introduction of oculopressure (Vörösmarthy). As a result of the preoperative reduction in vitreous volume caused by oculopressure the percentage of vitreous loss was reduced from 11% in 381 extractions to 6.2% in 802 cataract operations. A third group in which oculopressure, mannitol infusions and alphachymotrypsin zonulolysis was performed, did not show another significant reduction in the vitreous complication rate (from 6.2 to 5.5% in 506 operations). Nevertheless the authors recommend routine application of all three techniques used in the third group.

Topics: Cataract Extraction; Chymotrypsin; Hemorrhage; Humans; Intraocular Pressure; Intraoperative Complications; Mannitol; Preoperative Care; Vitreous Body

Postoperative bleeding was observed in 2 patients for whom alpha-chymotrypsin had been prescribed to prevent haematoma or oedema formation. In vitro experiments with citrated blood added with alpha-chymotrypsin evidenced (thrombelastogram, hirudin tolerance test, euglobulin-lysis time) an action on haemostasis. As compared to blanks, the application of an alpha-chymotrypsin dose which was 100-fold higher than those currently used in therapy resulted in a significant shortening of the r-time (thrombelastogram), delayed blood clotting (hirudin tolerance test) and a shortening of the euglobulin-lysis time. In vivo experiments are needed for further elucidation.

Topics: Chymotrypsin; Edema; Hemorrhage; Hemostasis; Humans; Postoperative Complications

Topics: Anemia, Sickle Cell; Chymotrypsin; Fibrinolytic Agents; Hemorrhage; Humans; Vitreous Body

Topics: Animals; Chymotrypsin; Cricetinae; Edema; Hemorrhage; Injections, Intramuscular; Male; Tongue; Wound Healing

Topics: Adult; Aged; Animals; Anterior Chamber; Chymotrypsin; Cornea; Drainage; Eye; Female; Follow-Up Studies; Foreign-Body Reaction; Glaucoma; Gold; Hemorrhage; Humans; Injections; Intraocular Pressure; Iris; Male; Middle Aged; Postoperative Complications; Rabbits; Sclera; Tonometry, Ocular

Topics: Arteriosclerosis; Blindness; Chymotrypsin; Diabetes Complications; Eye Diseases; Hemorrhage; Humans; Hypertension; Phlebitis; Visual Fields; Vitreous Body

Topics: Animals; Basement Membrane; Capillary Permeability; Chromium Isotopes; Chymotrypsin; Erythrocytes; Hemorrhage; Histamine Release; Hyaluronoglucosaminidase; Kidney Glomerulus; Lysophosphatidylcholines; Male; Microbial Collagenase; Rabbits; Rats; Serum Albumin; Serum Albumin, Radio-Iodinated; Trypsin; Venoms

Topics: Aged; Child; Chymotrypsin; Edema; Eye Diseases; Female; Hemorrhage; Humans; Male; Middle Aged

Topics: Chymotrypsin; Hemorrhage; Humans; Injections; Vitreous Body

Topics: Blood Coagulation; Cataract Extraction; Chymotrypsin; Epithelium; Hemorrhage; Humans; Phosphotransferases

Topics: Aminocaproates; Aminocaproic Acid; Blood Coagulation Disorders; Chymotrypsin; Enzyme Inhibitors; Fibrinolysin; Fibrinolysis; Hemorrhage; Kallikreins; Trypsin

Topics: Adolescent; Cataract; Cataract Extraction; Chymotrypsin; Estrogens, Conjugated (USP); Geriatrics; Hemorrhage; Humans; Lens, Crystalline