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ABSTRACT
Although perforating injuries of the lens capsule typically lead to traumatic cataract in humans and rats, capsular healing is observed regularly in injured rabbits and dogs. This is most likely because protein exudation in rabbits and dogs is much greater than that in humans and rats. Using isolated white Wistar rat lenses, rat lenses in vivo, and isolated human lenses, we attempted both to replace lens protein as well as develop techniques for microsurgically closing the capsule by applying a fibrinogen-based tissue adhesive. This application was effective in preventing traumatic cataract. Use of a fibrinogen-glued capsule graft yielded similarly good (but not better) results.
Perforating injuries of the lens capsule typically lead to traumatic cataract. Capsular healing (a clear lens except for a localized scar) is rare in humans, but is observed regularly in a variety of animals. Pilot studies have shown that perforating injuries of rabbit and dog lens capsules usually do not cause cataract but a localized scar. By contrast, rats, like humans, develop traumatic cataract after such injuries.
In 1937 Bakker suggested that lens proteins were the most important factor accounting for these differences.1 Protein exudation in rabbits and dogs is far greater than that in rats and humans. The post-traumatic protein content of the aqueous was also considered.2·3
We performed experiments with isolated and in vivo white Wistar rat lenses, and with isolated human lenses to learn how to prevent human traumatic cataract after capsule perforations. We attempted both to replace lens protein as well as develop techniques for microsurgically closing the capsule by applying a fibrinogen-based tissue adhesive.
Rabbit and Dog Lenses. Small, large, and large angular incisions via paracentesis were made in the anterior lens capsule of one eye of each of nine pigmented rabbits. Three received subconjunctival corticosteroid injections 24 hours before injury. In three others about one half of the aqueous was replaced by balanced salt solution (BSS®, Alcon) and heparin (10,000 IU/ml) after injury. In addition, large angular incisions were made in the anterior lens capsule of the left eye of each of four dogs.
White Wistar Rat Lenses. After injury, isolated white Wistar rat lenses were stored in plain balanced salt solution (Tables IA & 2A) in order to study (with a...