Increased glycosylation of human lens epithelial basement membrane in diabetes mellitus

We studied the nonenzymatic glycosylation of lens epithelial basement membranes (LEBM) of senile cataractous lenses of both diabetic and nondiabetic patients. The human LEBMs were isolated from surgically removed senile cataracts and purified by osmotic lysis and detergent treatments. Glycosylation assay of LEBMs was done using the colorimetric method of Fluckiger and Winterhalter. The glycosylation value ranged from 16.39 to 92.56 n mol/mg protein overall, with a mean of 63.54 +/- 24.56 n mol/mg protein for the diabetic specimens and a mean of 29.97 +/- 14.48 n mol/mg protein for the nondiabetic controls (P = 0.009). The study confirms our previous observation of in vivo glycosylation of the LEBM and further establishes that diabetic patients have a twofold increase in the amount of LEBM glycosylation when compared to their nondiabetic counterparts.

Increased glycosylation of human lens epithelial basement membrane in diabetes mellitus

We studied the nonenzymatic glycosylation of lens epithelial basement membranes (LEBM) of senile cataractous lenses of both diabetic and nondiabetic patients. The human LEBMs were isolated from surgically removed senile cataracts and purified by osmotic lysis and detergent treatments. Glycosylation assay of LEBMs was done using the colorimetric method of Fluckiger and Winterhalter. The glycosylation value ranged from 16.39 to 92.56 n mol/mg protein overall, with a mean of 63.54 +/- 24.56 n mol/mg protein for the diabetic specimens and a mean of 29.97 +/- 14.48 n mol/mg protein for the nondiabetic controls (P = 0.009). The study confirms our previous observation of in vivo glycosylation of the LEBM and further establishes that diabetic patients have a twofold increase in the amount of LEBM glycosylation when compared to their nondiabetic counterparts.

Glaucoma risk factors in primary open-angle glaucoma patients compared to ocular hypertensives and control subjects

To investigate the risk factors for glaucoma, we reviewed the clinical record of 361 primary open-angle glaucoma (POAG) patients, 178 ocular hypertensives (OH), and 927 controls without POAG or OH, randomly selected from an urban medical center eye clinic. Old age defined as > or = 55 year, (odds ratio ratio (OR) = 3.13 95% confidence interval (CI): 2.06-4.76, P < .0001), black race (OR = 2.58, 95% CI: 1.79-3.74, p < .0001), hypertension (OR = 1.709, 95% CI: 1.15-2.51, P < .0108), and diabetes mellitus (OR = 1.83, 95% CI: 1.08-3.09, P = .0308) were identified as significant risk factors in POAG compared to OH. Old Age (OR = 4.94, 95% CI: 3.62-6.76, p < .0001), and black race (OR = 2.04, 95% CI: 1.59-2.61, P < .0001), HTN (OR = 1.63, 95% CI: 1.26-2.11, P = .0002), and DM (OR = 1.40 95% CI: 1.02-1.92 P = .0450) were also significant risk factors when compared to normal controls. However, when the 361 POAG patients were compared to 361 controls matched with respect to age, race, and sex, hypertension and diabetes mellitus did not appear to be independent risk factors. Family history of glaucoma was found to be a risk factors more significantly for OH (OR = 6.79, 95% CI: 4.39-10.50, P < .0001) than for POAG (OR = 2.83, 95% CI: 1.90-4.21, P < .0001) compared to the matched control subjects. The apparent importance of hypertension and diabetes as risk factors for POAG may therefore be due at least in part to a higher prevalence of hypertension and diabetes mellitus in the elderly than the young and also in the black race as risk factors for glaucoma may be in part due to an increased prevalence of hypertension and diabetes mellitus in the elderly and blacks. Positive family history of glaucoma appears to be a risk factor more specifically for elevated intraocular pressure than for glaucomatous visual field defects.

Positive family history of glaucoma is a risk factor for increased IOP rather than glaucomatous optic nerve damage (POAG vs OH vs normal control)

To elucidate the family history of glaucoma (FHG) as a risk factor for ocular hypertension(OH) vs glaucomatous optic nerve damage, we reviewed the clinical records of 361 primary open-angle glaucoma(POAG) patients, 178 OH subjects, and 927 normal controls randomly selected from an urban medical center eye clinic. The prevalence of a positive FHG was 27% in the POAG patients, 47% in the OH subjects, and 11% in the normal controls. Whereas a positive FHG was a significant risk factor for both OH and glaucoma compared to normal control subjects (OR = 7.56, 95% CI: 5.27-10.85, P < .0001 for OH; OR = 3.15, 95% CI: 2.31-4.31, P < .0001), it was a risk factor more significantly for OH than for glaucoma being significantly more prevalent in OH than in POAG (OR = 2.40, 95% CI: 1.65-3.49, P < .0001). These results suggest the importance of additional risk factors other than IOP for glaucomatous optic nerve damage.

Computerized optic disc analysis with adjunct stereoscopic viewing of disc photographs

We have investigated the potential usefulness of stereoscopic viewing of optic disc photographs in marking the disc margin in computerized analysis with the Rodenstock Analyzer in 48 eyes of 26 patients with ocular hypertension or primary open-angle glaucoma. Marking of the disc margin without Method 1) and with the aid of stereoscopic viewing of disc photographs (Method 2) three consecutive times by one observer at the same sitting, and three subsequent topographic analyses of each method were done on each 48 eyes. The mean intraphotographic variabilities of such optic disc parameters as rim area, and cup volume with Method 2 were significantly less than those with Method 1 overall and in 16 eyes (33%) with poor video images having an ill-defined disc margin (p less than 0.05 for each), but not in 32 eyes (67%) with clear video images having a well-defined disc margin. Furthermore, the mean paired differences of rim area, disc area and cup volume between the two methods (Method 1 minus Method 2) were also statistically significant overall and in eyes with poor video images (p less than 0.05 for each).

A Case Report of Binkhorst Iris Clip lens Implantation

Authors performed a Binkhorst iris clip lens implantation after intracapsular cryoextraction in a senile cataract patient, aged 76, male. In this both eye cataract patient, only right eye was received a successful implantation of intraocular lens (Binkhorst iris clip lens) under operating microscopy. There was no complication during and after operation. Until one year after operation no complication was found, and corrected vision was normal (20/20).

Trabeculectomy

In a critical review of trabeculectomy, some factors and steps which I consider to be of importance for its successful outcome are discussed. Trabeculectomy is a misnomer because its success does not depend on inclusion of trabecular meshwork or Schlemm's canal in the excised tissue. Furthermore, development of conjunctival bleb is seen in most, if not all eyes with successful trabeculectomy. Trabeculectomy is then a form of guarded filtering procedure. Several factors seem to determine the outcome of the final intraocular pressure control after trabeculectomy. Some of the factors are the tightness of closure of the lamellar scleral flap, the thickness of the lamellar scleral flap, the kind of sutures used for closure of the flap, the amount of cauterization applied to the scleral wound, and the size of the window defect relative to the size of the lamellar scleral flap. Trabeculectomy, as reported by others, seems to be a remarkably successful and safe procedure. It, however, is with disappointing results in aphakic glaucomas. Although we do not yet know how many of the eyes with seemingly successful trabeculectomy will remain so many years from the time of surgery, from all available indications at the present, trabeculectomy will stay with us as a primary procedure for open-angle and chronic angle-closure glaucomas in adult phakic eyes.