The Use of Hyaluronidase in some Corneal Affections

When the function of the lacrymal gland is stopped by excision or X-ray treatment, the result is sometimes a filamentary keratitis. It is conceivable, therefore, that this keratitis might be caused by a lack of tears. Many times, however, we see a filamentary keratitis in cases where the lacrymal flow is normal or even excessive, so that it is more likely that this affection is caused not by a lack of tears, but by the lack of a substance in the lacrymal fluid. As a hypothesis, I have thought of the possibility that this substance might be lysozyme. Pure lysozyme is difficult to get, but hyaluronidase is very nearly the same; perhaps identical with it. I have therefore treated some patients with filamentary keratitis with hyaluronidase as eye drops. In six cases of long standing, where every other treatment had failed, immediate results were obtained; in one case, a boy of 12 years, no effect at all was seen. Hyaluronidase proved very effective too in many cases of superficial punctate keratitis. The substance is manufactured under the name of “Hyason” by the firm of Organon, Oss, Holland. A solution of 5 Units per cc. was used four or five times daily as drops; it is quite painless. We saw no better results from stronger solutions. As the enzyme deteriorates quickly in solution, it was stored in the refrigerator and a fresh ampoule was made each morning. If the treatment has any effect, the effect comes fast and the keratitis is healed in one or two days; there seems no point in continuing any longer if no effect is seen after this time. Some of my cases have had a relapse after some months and have responded again to the same treatment; in some others the cure seems to be definite. 64 D e k k i n g ‚ The Use of Hyaluronidase in some Cornea! Affections Summary. Eye drops containing 5 Units of hyaluronidase per cc. proved very effective in many cases of filamentary keratitis and superficial punctate keratitis. Zusammenfassung. Mit einer Lösung, die 5 E Hyaluronidase pro cc enthält und 4 bis 5mal pro Tag als Augentropfen benützt wird, wurden aus-gezeichnete Erfolge erzielt in hartnäckigen Fallen von Keratitis filamentosa und Keratitis superficialis punctata. Resume. L’auteur a vu des résultats excellents dans les kératites fila-mentaires et les kératites ponctuées superficielles, d’un collyre contenant 5 unites de hyaluronidase par cc. Buchbesprechungen – Books Review – Livres Nouveaux Antonio Grignolo: Gli Antibiotici in Oîtalmologia. Prefazione del Prof. G. B. Bietti. Edizione Minerva Meddca S. A., Torino. 321 p. 1948. In dem Vorwort von Professor Bietti, dem Direklor der Universitätsaugen-klinik in Pavia, wird gesagt, daß bei dem großen Aufschwung, welchen die Behandlung mit Antibiotica in den letzten Jahren genommen hat, eine zu-sammenfassende Darstellung, die bisher fehlte, sehr wichtig ist. In dfer Augen-heilkunde sind Dosierung und Art der Anwendung dieser Mittel zum Teil· ab-