Effects of intracameral administration of α-chymotrypsin on intracapsular lens extraction and postoperative outcome in clinically normal dogs

David J. MaggsDepartment of Veterinary Medicine and Surgery College of Veterinary Medicine, University of Missouri, Columbia, MO 65211

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Mark P. NasisseDepartment of Veterinary Medicine and Surgery College of Veterinary Medicine, University of Missouri, Columbia, MO 65211

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Ruth M. MarrionDepartment of Veterinary Medicine and Surgery College of Veterinary Medicine, University of Missouri, Columbia, MO 65211

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Nelson H. Priddy IIDepartment of Veterinary Medicine and Surgery College of Veterinary Medicine, University of Missouri, Columbia, MO 65211

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John R. DodamDepartment of Veterinary Medicine and Surgery College of Veterinary Medicine, University of Missouri, Columbia, MO 65211

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Abstract

Objective—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).

Animals—6 young adult male dogs without evidence of systemic or ocular disease.

Procedures—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.

Results—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.

Conclusions and Clinical Relevance—Intracameral administration of 75 U of α-chymotrypsin 7 minutes before ICLE facilitated lensectomy without apparent adverse effects in clinically normal dogs.

Abstract

Objective—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).

Animals—6 young adult male dogs without evidence of systemic or ocular disease.

Procedures—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.

Results—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.

Conclusions and Clinical Relevance—Intracameral administration of 75 U of α-chymotrypsin 7 minutes before ICLE facilitated lensectomy without apparent adverse effects in clinically normal dogs.

Contributor Notes

Dr. Maggs' present address is Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

Dr. Nasisse's present address is Carolina Veterinary Specialists, 501 Nicholas Rd, Greensboro, NC 27409.

Dr. Marrion's present address is Essex County Veterinary Referral Hospital, 247 Chickering Rd, North Andover, MA 01845.

Dr. Priddy's present address is Veterinary Specialists of Alaska Professional Corporation, 3330 Fairbanks St, Anchorage, AK 99503.

Supported in part by a grant from the University of Missouri Committee on Research.

Presented in part in abstract form at the 29th annual meeting of the American College of Veterinary Ophthalmologists, Seattle, October 1998.

The authors thank Greg Petroski for assistance with the statistical analysis and Lisa Boland for technical assistance.

Address correspondence to Dr. Maggs (djmaggs@ucdavis.edu).
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