Treatment of Infected Corneal Ulcer by Subconjunctival Injection of Penicillin in Doses of 1,000,000 Units
1950; BMJ; Volume: 34; Issue: 1 Linguagem: Inglês
10.1136/bjo.34.1.16
ISSN1468-2079
Autores Tópico(s)Corneal Surgery and Treatments
ResumoIN earlier communications it has been shown that adequate con- centrations of penicillin (can be obtained in the corneaand aqtueous Of the rabbit l)\ sub(onjunctiVal injections.It was also slhown tlat by increasinllg tlhe close nlot onliy! is the level of concentration increased but it atlso persists longer.Thlle addition of vasoconstric- tors like adrenalin still furi-thelrincreases both levels and persis- tence.In the rabbit liglh aqueotus levels persisting for as long as 48 hours ()otild be obtained xx ithi a sul)(bonijun(tival injection of 1,000,000 units crystalllinie penicillin in 1 ml. of adrenalin (SoIrsb)v and ngar, 19r46, 1948a).TIlle value of silb(conjtinctival injections of penicillin clinically lhas beenreiorded in txxc) previous studies.Originally a dose of 50,(0() ulnits w\a"-s tised, and to mainlttain adequate levels these injections had to 1b given at (i-hourly intervals (Sorsbv and Reed, 1947).Subsequently the dose w7sas increased progressively to 500,000 unlits in oe injection at 24 -hourly intervals (Sorsby and lingar, 1948b).TIhlese large closes w-ere tole(rated if wh}ite crystalline penicillin was used.Th11e presemslt study-covers () onsecutive cases of infectecl corneal tilcer, generallyconiplicaited b)y hvpopvon, and treated with doses of 1,000,00() Units at either 24-lhourly or 48-hourly intervals.Cases of hypopvon iritis x-ere.excluded.The series fell ilnto tmxo groups, those in which the eve was previously healthv and those in w-hicl it was not.In all (ases the diagnosis of infected corneal ulcer was established o*n the clinical evtidence of the ulcer show-ing eitlher a slouglhv base, or slouglhinfiltrated margins with or without inter- stitial infiltration.In 25 cases hypopyon was present, and in all cases balcteriologi(cl examination was carried out, generally w,ritl positive results.CASE REPORTS PiRE IOUSLY HEALrT-Hy EvES (Tl iable AV)Of the 1, cases in tlhis group, 14 respponded promiiptly to penicillin alnd dlidl vell.Th1e 8 paltients; who did not respond to penicillin
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