Treatment of Symptomatic Vitreous Opacities with Pharmacologic Vitreolysis Using a Mixure of Bromelain, Papain and Ficin Supplement

Abstract

Methods: Our research was scheduled in Southern Taiwan between April 2017 and December 2017. A total of 280 patients presenting 280 eyes were enrolled and received a series of ocular examinations. Each of our specially designed capsules contained 190 mg bromelain, 95 mg papain and 95 mg ficin. In Experiment 1, 120 subjects were classified into Group 1 (one symptomatic vitreous opacity (SVO)) and Group 2 (multiple SVOs) which each subject taking two capsules every day. In Experiment 2, 160 eyes with SVOs were randomly divided into four groups including the placebo; low protease group (LPG) (1 capsule/day); middle protease group (MPG) (2 capsules/day); and high protease group (HPG) (3 capsules/day), respectively. Finally, we analyzed the change in SVOs and checked the numbers of SVOs during and after three months in our study. Results: In Experiment 1, 80 subjects with one SVO were reduced to 24 cases (30.0%; 24/80), 40 participants with multiple SVOs were decreased to 11 cases (27.5%; 11/40) three months later. In Experiment 2, the numbers of patients with SVOs in the placebo group was similar after three months. The disappeared rates of SVOs by treatment with fruit enzymes was 65.5%, 70.0% and 75.5% and for those taking one, two and three capsules daily as therapy, respectively. Hence, the results showed that the effects of treating SVOs in a dose-dependent manner; the higher the dose, the greater the SVO reduction. We also suggested that the mechanisms of dissolving and absorbing SVOs may be due to the proteinase and associated hydrolysis and antioxidant activities that may clear the compromised opacity and scavenge free radicals in the vitreous. In addition, there were no serious side effects or discomfort during treatment. Conclusion: We demonstrated that mixed-fruit-enzyme including bromelain, papain and ficin may excise SVOs and even eliminate intraocular hemorrhage by cleaving the collagen fibrils and cellular debris that may induce ocular floaters.