We examined 11 cataractous lenses (or aspirated lens matter from extracapsular extractions) from patients ranging in age from 55 to 84 years who used allopurinol on a long-term basis (more than two years). Phosphorescence analyses demonstrated the characteristic allopurinol triplet in these lenses. When we analyzed normal lenses from patients taking allopurinol in a similar manner we found no evidence of allopurinol photobinding. These data indicated that allopurinol has a cataractogenic action only in patients in whom the drug has become photobound within the lens. Long-term allopurinol therapy does not necessarily cause or enhance cataracts in all patients. There may be a relationship between ultraviolet radiation exposure and circulating allopurinol levels (and perhaps renal function) in the genesis of photosensitized allopurinol cataracts.
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