3 · Anticollagenolytics & anti-melt agents
Aprotinin — antiprotease (historical)
Review — modulators of corneal healing › 3 · Anticollagenolytics & anti-melt agents › Aprotinin — antiprotease (historical)
Aprotinin — antiprotease (historical)
Bovine serine protease inhibitor (plasmin, trypsin, kallikrein, elastase)
Oxford IV
Weak / Investigational
Past · niche
Mechanism of actionInhibits the serine proteases (plasmin, neutrophil elastase) involved in stromal collagenolysis → reduces melting and stabilizes the ulcer bed. Also a component of fibrin glues.
IndicationsSterile stromal melting/keratomalacia (burns, rheumatoid PUK, post-surgical) — largely historical/second-line, superseded by doxycycline, serum, amniotic membrane.
Route & dosageTopical (compounded eye drops, ~10,000 KIU/mL) most common, or as a component of fibrin glue. No standardized ophthalmic dosage.
Level of evidenceOxford IV · Scale: Weak / Investigational. Systemic aprotinin (Trasylol) was withdrawn (2007–08) for safety reasons — enthusiasm has been limited.
| FDA / EU MA | Not approved for topical ophthalmic use; systemic use restricted. Ocular use is compounded/historical. |
|---|---|
| France / USA | Compounded/historical; limited availability. |
| Asia | Same, marginal. |
Context: antiprotease reviews of keratomalacia (old and scarce human literature; use mostly veterinary).