ANTERIOR SEGMENT COLLAGENASE ACTIVITY IN CHILDREN WITH KERATOMALACIA

The total proteins and collagenase activity in tears as well as alpha( 2)-macroglobulin (anticollagenase) and vitamin A levels in serum, were estimated in 35 malnourished children with corneal lesions, in 30 mal nourished controls (age matched) without corneal lesions, and in 19 no rmal children. Also eye swabs from some of the children were cultured for bacteria. Significant decreases in the serum vitamin A and alpha(2 )-macroglobulin levels and in tear total protein levels were observed in malnourished children when compared with the normal values. Further , the reduction was more pronounced in children with corneal lesions t han in those without them. Interestingly, the tear collagenase activit y was significantly elevated in malnourished children with corneal les ions as compared with that in those without lesions or in normal child ren. Similarly, more bacteria could be cultured in samples from malnou rished children (with/without corneal lesions) than in those from norm al children. These observations clearly indicate that the elevated lev els of anterior segment collagenase may play an important role in the pathogenesis of corneal lesions.