alpha-chymotrypsin and Hyphema

To assess the intraoperative and postoperative clinical effects and histologic effects of intracameral administration of α-chymotrypsin in clinically normal dogs undergoing standard intracapsular lens extraction (ICLE).. 6 young adult male dogs without evidence of systemic or ocular disease.. All dogs underwent bilateral ICLE 7 minutes following injection of 75 U of α-chymotrypsin or an identical volume (0.5 mL) of a commercially available balanced saline solution (BSS) into the posterior chamber of the eye. Ease of lens extraction was subjectively assessed and intraoperative intraocular hemorrhage and fibrin accumulation scored. For 27 days after surgery, ocular hyperemia and discharge, chemosis, corneal edema, hyphema, and aqueous flare were scored, and intraocular pressure (IOP) was measured. Thirty days after surgery, histologic evidence of anterior synechia, collapse of and inflammation within the iridocorneal angle, and iritis were scored.. In 5 of 6 dogs, the surgeon was able to correctly identify the eye treated with α-chymotrypsin on the basis of ease of lens extraction. Mean intraoperative intraocular hemorrhage and fibrin scores for BSS-treated eyes were significantly higher than for α-chymotrypsin-treated eyes. Postoperatively, there were no significant differences between treatments for any clinical variables, including IOP Histologic scores were not significantly different between treatments for any variable. Vision was lost as a result of glaucoma in 1 α-chymotrypsin-treated eye and 1 BSS-treated eye.. Intracameral administration of 75 U of α-chymotrypsin 7 minutes before ICLE facilitated lensectomy without apparent adverse effects in clinically normal dogs.

Topics: Animals; Anterior Chamber; Cataract Extraction; Chymotrypsin; Corneal Edema; Dog Diseases; Dogs; Euthanasia; Eye; Eye Diseases; Glaucoma; Hyperemia; Hyphema; Intraocular Pressure; Lens Capsule, Crystalline; Male

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

Topics: Animals; Chromium Isotopes; Chymotrypsin; Erythrocytes; Hyaluronoglucosaminidase; Hyphema; Rabbits; Radioisotope Dilution Technique

Topics: Aged; Anterior Chamber; Aqueous Humor; Cataract Extraction; Chymotrypsin; Corneal Dystrophies, Hereditary; Eye Diseases; Female; Glaucoma; Humans; Hyphema; Iris; Keratitis; Penicillin G; Postoperative Complications; Retinal Detachment; Therapeutic Irrigation