THE INTRA-OCULAR USE OF PENICILLIN

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Abstract
In rabbits, 0.15 ml. (200-1500 U.) penicillin injd. into the ant. chamber produces a reactive aseptic uveitis within 18 hrs. It subsides in 3-24 days. A coagulum forms on the iris immediately after or <1 hr. and disappears in 1-4 hrs. When minute yellow glistening crystals fill the ant. chamber in the first few hrs. after injn., a severe uveitis follows. The uveitis is caused by impurities, although pure penicillin of any strength produces a very slight reaction. Injn. of penicillin into the vitreous produces a localized opacity which later diffuses and then becomes permanent. A severe exudative retino-chor-oiditis develops in 5-7 days, followed by retinitis proliferans and optic nerve atrophy. There is complete neuro-retinal degeneration and choroidal thickening with fibrous tissue replacement. A degenerative iritis occurs 4-5 wks. after injn. These severe reactions are due to impurities and do not occur with pure penicillin. Penicillin in the ant. chamber exerts a strong inhibitory effect for about 6 hrs. after injn. When introduced into the vitreous, it partially diffuses into the aqueous. Its final disappearance is less rapid from the vitreous. In man, introduction of conc. penicillin into the ant. chamber is justifiable and sometimes beneficial in severely injured or infected eyes. An intact posterior lens capsule is essential to prevent contact between penicillin and vitreous. A reactive iritis lasting 4 days developed in the cases which showed recovery. Intraven. injn. of penicillin is of little value in infections of the aqueous and vitreous.

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