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R. A. Eiferman, D. P. DeVore; Acylation Reactions Soften and Liquify Cataracts: A Novel Method to Facilitate Cataract Surgery. Invest. Ophthalmol. Vis. Sci. 2010;51(13):5432.
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To demonstate the ability of acylation reactions to sever the abnormal crosslinks leading to cataract formation. These reactions solubilize lens proteins so the cataract can be dispersed, liquified and removed by aspiration. This is accomplished by replacing the positive (NH3) charge with a chemical moiety that exhibits a negative or neutral charge on deprotonated free amines and reduces the pKa to a more acidic level thereby rendering the proteins more soluble at a neutral pH.
Explanted rabbit lenses were exposed to UV light to induce cataract formation. A needle delivery system (which adds the proper amount of treatment solution) was developed to inject the reagents directly into the lens nucleus. This was also performed on explanted human cataractous lenses ranging from grade 3 to grade 4. Injection of specific acylation agents followed pre-treatment injections with a slightly alkaline buffer solution to first deprotonate free amines.
Injections of acylation compounds into the lens nucleus resulted in complete dispersion and partial liquification of the UV induced rabbit cataracts and grade 3 human cataracts. Grade 4 human cataracts were partially dispersed after acylation treatment.
Injection directly into the lens nucleus during cataract surgery can soften and liquify cataracts and may permit removal by simple aspiration. Since cataract is the leading cause of world blindness, this compound may by of tremendous importance in simplifying cataract surgery.
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