RESULTS

　　As a result of cornea burn in the optical zone a dense primary dimness is formed according to the “porcelain plate”type 10 mm in diameter．In the damaged section the cornea loses an epithelial cover．In the control group，taking into account an isolated character of the damage with the presence of a rim of undamaged cornea the process of epithelization of the defect proceeded in a wavelike way．In connection with presence of the regeneration source from the undamaged paralimbal section of the cornea for 3?d an almost full cover of deepithelized section occured．However，weakly solded with underlying burnt stroma，the neoplasm epithelium was easily seized making a vast defect by 6-d observation．During the 2nd～3rd week of the observation an exacerbation peak of erosion process was marked，connected with progressing trophic disorders in the damaged eye tissues．Almost in a half of the cases （18?eyes：47.3%)those were deep，up to Descemet’s membrane，defects of the cornea stroma．From d 13 to d 15 of observation the epithelization activized and was over by observation for 35～38 d．

　　The inflammatory reaction of the front section of the eye kept up to 38～40 d．The outcome of the burn process of this group of animals in 100％ cases was the formation of a dense wall-eye．The course of the burn disease in the group of the operated animal was different．The inflammatory reaction increased on d?1，reaching maximum on d 7～14 and gradually reduced with almost complete liqudation of observation by d?30．The erosion of the transplant was kept from d 6～7 to d 21～23 of observation． The data are presented in Tab．1．

Tab．1 Eye burn disease symptoms cessation terms

　　in observed groups of animals（±s）

　　in the operated group of animals complications from the transplant in the form of deep erosions were observed on 5 eyes （14．7％）．In the outcome of the burn process in the experimental group on 24 eyes （70％） transparent and half transparent dimnesses were formed．Only on 10 eyes （29．5％） dense wall-eyes were formed．

　　The study of the proteolytical activity（PA） level in the blood serum showed the following（Tab．2）．During d?1 of observation on the background of the developing phenomena of inflammation in the front section of the eye PA increases in both groups：twice as much in the experimental group and three times as much in the control group．

Tab．2 Blood serum proteolitical activity dynamics in the

　　control and experimental animals group（n／kat／l）

Observation 　　terms （d）	Controlgroup		Experimental group		P
	n	±s	n	±s
Before burn	5	1.15±0.22	5	0.98±0.22	＞0.05
1	19	3.74±0.93	10	2.47±0.82	＞0.05
3	8	4.76±0.92	9	3.16±0.9	＞0.05
7	9	8.03±0.96	7	2.62±1.17	＜0.05
14	10	6.21±0.72	8	83.81±1.02	＞0.05
21	6	6.50±1.22	7	0.9±0.18	＜0.001
30	6	2.46±0.77	6	0.8±0.081	＞0.05

　　F21urther increase of PA reached maximum in the control group on d 7 and till d 14～d 21 this index remained high corresponding to mostly expressed inflammatory reaction．By observation for 30 d，the PA index reduced without reaching the initial level．

　　In the experimental group the PA index was higher than the initial level from d 3 to d 14．However，the degree of the PA increase in the experimental group was lower than in the control one．From d 21 to d 30 of observation， the PA index in the main group returned to the initial level，while in the control group it remained high．

　　The PA indices in the camera moisture were 4 times lower than in the blood serum （Tab．3）．On d 1 these indices increase twice as much and then gradually grow reaching maximum on d 14．The PA indices in the control group were higher than in the experimental one with the reliable difference on d 7 and d 14．Further in both groups the PA level decrease was observed，reaching initial values by observation for 30 d．

Tab．3 Camera moisture proteolytical activity dynamics in the

　　control and experimental groups of animals（n／kat／l）

Observation 　　terms（d）	Control group		Experimental group		P
	n	±s	n	±s
Before burn	4	0.31±0.40	4	0.29±0.15	＞0.05
1	5	0.62±0.07	5	0.52±0.06	＞0.05
3	4	0.47±0.045	4	0.34±0.04	＞0.05
7	5	0.61±0.022	5	0.44±0.058	＜0.05
14	5	1.33±0.18	5	0.82±0.082	＜0.05
21	4	0.9±0.07	5	0.7±0.067	＞0.05
30	4	0.32±0.02	4	0.24±0.08	＞0.05

　　DISCUSSION

　　The results of these experiments showed that with the help of proteolytical ferments，it is possible to obtain tearing away of necrotically changed cornea layers and thus prepare the cornea for the following lamellar keratoplasty．The carrying out of such operation allows to improve the course of the eye burn disease．

　　In the experimental group the cessation of the inflammatory reaction began earlier and finished earlier．The epithelization of the transplant erosion was also achieved earlier in comparison with the cornea erosion in the control group of animals．More favorable course of the eye burn disease reflected positively also on the PA indices of the blood serum and camera moisture．As a whole，the dynamics of these indices corresponds to the dynamics of the inflammatory reaction in both groups．The increased level of the PA of the blood serum in the control group remained increased during the entire term of observation with the highest indices from d 7 till d 21．In the experimental group，the PA indices of blood serum were increased only to 14-d observation．In the camera moisture the maximum increase of the PA in both groups was marked from d 7 to d 21，but in the main group this index on d 7 and d 14 was reliably lower than in the control group．More favorable course of the burn disease in the main group led to its better results，in 70．5％ it was allowed to obtain the transparent and half-transparent grafting of the transplant（Fig．4），while in the control group in 100％ of the cases the cornea wall-eyes were formed．

　　The application of proteolytical ferments in the early terms allows to create better conditions for the lamellar keratoplasty with the severe eye burns．

　　The urgent keratoplasty with the preliminary ferment necrectomy promotes more favorable course of the burn disease and achieves better outcome in the treatment．

　　REFERENCES

　　1，Puchkovskaya NA，Sulgina NS，Nepomyachaja VM．The pathogenesis and treatment of eye burns and their seguelae．Kiev，1973，197

　　2，Chalanova RI．Izychenie necroliticheskix svojstv nekotorix proteoliticheskix fermentov pri schelochnix ojogax glaz．Ophthalmology，1998，4∶277

(收稿：1999－12－10)

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