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Therapeutic effects of heparin on Pseudomonas-induced corneal ulceration
Fifty organisms of Pseudomonas aeruginosa were injected intralamellarly in both eyes of 60 albino rabbits. Twenty-four hours later, all eyes were graded and stratified into six groups of ten rabbits with equivalent infections. Treatment was begun with gentamicin alone or 0.3% polymyxin B alone, and in combination with acetylcysteine, 0.3M edetate disodium, and 2.500 units/ml of heparin sodium, four times daily. We also compared topical colistin and colistin and topical heparin. After two weeks, those corneas treated with polymyxin B and topical heparin showed a reduction in ulceration, corneal thinning, and descemetocele formation compared to those treated with polymyxin B alone. Based on these studies, heparin was administered topically, four times daily, to three patients with Pseudomonas-induced corneal ulcers in addition to antibiotics. Before treatment all corneas showed evidence of corneal liquefaction and two of the corneas were in imminent danger of perforation. After therapy, no corneas perforated; one patient recovered visual acuity of 6/9 (20/30), one patient recovered visual acuity of 6/6 (20/20) after keratoplasty, and the third has a vascularized leukoma.
Fifty organisms of Pseudomonas aeruginosa were injected intralamellarly in both eyes of 60 albino rabbits. Twenty-four hours later, all eyes were graded and stratified into six groups of ten rabbits with equivalent infections. Treatment was begun with gentamicin alone or 0.3% polymyxin B alone, and in combination with acetylcysteine, 0.3M edetate disodium, and 2.500 units/ml of heparin sodium, four times daily. We also compared topical colistin and colistin and topical heparin. After two weeks, those corneas treated with polymyxin B and topical heparin showed a reduction in ulceration, corneal thinning, and descemetocele formation compared to those treated with polymyxin B alone. Based on these studies, heparin was administered topically, four times daily, to three patients with Pseudomonas-induced corneal ulcers in addition to antibiotics. Before treatment all corneas showed evidence of corneal liquefaction and two of the corneas were in imminent danger of perforation. After therapy, no corneas perforated; one patient recovered visual acuity of 6/9 (20/30), one patient recovered visual acuity of 6/6 (20/20) after keratoplasty, and the third has a vascularized leukoma.